Inhaled analgesics for the treatment of prehospital acute pain—A systematic review
Authors' conclusion
We found low-quality evidence suggesting that both MF and N2O are safe and may have a role in the management of pain in the prehospital setting.
Study context
- Population
- Prehospital emergency adult patients with acute pain
- Participants
- 56,535 patients · 7 studies
- Comparison
- Inhaled analgesics vs other analgesics or placebo
- Outcome
- Pain reduction
Methodological detailsPRISMA, Grading of Recommendations Assessment, Development, and Evaluation (GRADE), Cochrane methods, no meta-analysis possible, PRISMA, GRADE and Cochrane methods applied, All steps by minimum of two individual researchers, Databases searched (Cochrane Library, Epistemonikos, CRD, PubMed, EMBASE), updated March 2024, Study designs: one RCT (n = 60), one randomised non-blinded study (n = 343), one randomised open-label study (n = 270); remainder prospective or retrospective observational studies, No combined meta-analysis possible; evidence of low or very low quality (GRADE)
- PRISMA
- GRADE
- Cochrane methods
- No meta-analysis possible
- PRISMA, GRADE and Cochrane methods applied
- All steps by minimum of two individual researchers
- Databases searched (Cochrane Library, Epistemonikos, CRD, PubMed, EMBASE), updated March 2024
- Study designs: one RCT (n = 60), one randomised non-blinded study (n = 343), one randomised open-label study (n = 270); remainder prospective or retrospective observational studies
- No combined meta-analysis possible; evidence of low or very low quality (GRADE)
Pooled result
As reported in the abstract
- N2O may reduce pain vs placebo, but not vs intravenous (IV) paracetamol, and may be less effective vs morphine and MF
- MF may reduce pain vs paracetamol, ketoprofen, tramadol and fentanyl
- Low or very low quality evidence (GRADE)
Safety
Adverse events
- Both agents may be associated with marked but primarily mild adverse events (AEs)
Original publication
Inhaled analgesics for the treatment of prehospital acute pain—A systematic review. Acta Anaesthesiol Scand. Published 26 September 2024. doi:10.
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