Penthrox is an inhaled, patient controlled analgesic for use with moderate to severe acute pain associated with trauma.  Not to be used in atraumatic pain, chronic pain, children or pregnancy.

Rapid onset of analgesia lasting 25-60 minutes depending on rate and depth of inhalation.  Wears off 10 minutes after last inhalation.

Contraindications (CHECK ALLL):

• Cardiovascular instability/shock
• Hypersensitivty to methoxyflurance
• Elevated temperature from an anaesthetic – personal or FHx of malignant hyperthermia
• Consciousness reduced (GCS <14/15)
• Kidney impairment (CKD 4 or 5)
• Age <18
• Lung or respiratory ventilatory impairment eg known T2RF, OSA (okay to use in asthmatics and mild COPD)
• Liver impairment
• Last penthrox administation.  Max 2 doses (6mls) per 24 hours.  Max 15mls per 7 day

Warn patient regarding potential temporary side effects:  Dizzyness, headache, tiredness, nausea, coughing, altered state of conscioussness, blurred vision.

If using penthrox for joint manipulation and it is unsuccessful then you can procede to conscious sedation if felt appropriate.