Abstract

Background: Methoxyflurane (C3H4Cl2F2O, Penthrox), introduced initially as a volatile anesthetic in the 1960s, was later discontinued as a general anesthetic due to nephrotoxicity. However, recent studies have highlighted its significant analgesic properties at subanesthetic doses. This literature review explores the evolution of methoxyflurane from a general anesthetic to a widely used analgesic, focusing on its current applications, safety profile, environmental impact and regulatory aspects.

Methods: PubMed, Embase, and Cochrane Library were searched in July 2024 for articles related to methoxyflurane.

Results: Effectiveness: Methoxyflurane offers rapid and effective pain relief. Its self-administration feature by inhalation provides significant advantages in situations where time-sensitive pain management is critical.

Safety: The safety profile of methoxyflurane is favorable, with only mild, transient side effects such as dizziness and nausea. No significant long-term renal or cardiovascular complications have been observed at subanesthetic doses. Environmental Impact: Compared to other volatile anesthetics, methoxyflurane has a low global warming potential, due to its short atmospheric lifetime and low radiative efficiency.

Conclusion: Methoxyflurane has proven to be a potent and effective analgesic, particularly in emergency and trauma care. Furthermore, its lower environmental impact compared to other anesthetics aligns with growing sustainability goals in healthcare. Despite its benefits, further research is necessary to address gaps in its use for vulnerable populations, such as children and pregnant women, and to explore its broader clinical applications and ecological footprint.