Évaluation de l’utilité et de l'efficacité du méthoxyflurane sous forme inhalée sur la prise en charge immédiate de la douleur post-traumatique aux urgences du CH Dax avant toute prise en charge médicale : une étude observationnelle prospective

Abstract : Introduction. Pain, as a symptom, is very frequent in patients admitted to the emergency department. In the Dax Hospital Center (DHC), initial treatment of acute post-traumatic pain, by the admission and triage nurse, is limited to paracetamol. Methoxyflurane (Penthrox®), by inhalation, has been approved in France since 2017 for the treatment of moderate to severe acute post-traumatic pain and may be an alternative path of treating pain more efficiently, with a rapid onset of action. Methods. This was a prospective, single center, observational study to evaluate Penthrox® and paracetamol in the treatment of moderate to severe acute post-traumatic pain in the emergency department of DHC, during two periods. The main endpoint of this study was pain, evaluated by using the 0-to-10 Numerical Rating Scale (NRS), before and after pain-killer administration. Patients and hospital staff satisfaction toward treatment has also been evaluated. Results. Hundred-twenty-one patients have been included. Sixty-seven in the paracetamol treatment period and 54 in the Penthrox® treatment period. A mean decrease of 1,1 and 2,7 on the 0-to-10 NRS of pain has been observed in patients treated with paracetamol and Penthrox®, respectively. When treated with Penthrox®, 74% of the patients felt relieved in less than 15 min and half of the patients encountered at least one adverse event of mild intensity which resolved rapidly. Conclusion. Penthrox® seemed to act more rapidly and efficiently against acute post-traumatic pain when compared to paracetamol, with a good safety profile. This resulted in a higher satisfaction of patients and hospital staff toward pain management. However, the cost/efficacy ratio of Penthrox® calls for a more restrictive use of this treatment.
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Master Thesis
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Éric Hurst. Évaluation de l’utilité et de l'efficacité du méthoxyflurane sous forme inhalée sur la prise en charge immédiate de la douleur post-traumatique aux urgences du CH Dax avant toute prise en charge médicale : une étude observationnelle prospective. Médecine humaine et pathologie. 2019. ⟨dumas-02151104⟩

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