By: 5 April 2017
Updated guidelines could transform the management of emergency pain relief in the Republic of Ireland

Galen Ltd announced that the Pre-Hospital Emergency Care Council (PHECC) in Ireland has issued its new pain management clinical practice guidelines for emergency care teams and now includes the inhaled pain relief medication, Penthrox® (methoxyflurane) [1-3]. 

The aim of these guidelines is to provide a comprehensive and co-ordinated approach to how patients receive optimal care in the pre-hospital setting, so the updated guidelines are a welcome development for healthcare professionals managing trauma pain across the Republic of Ireland.

Penthrox is a patient-controlled, inhaled medication, which provides rapid relief from acute pain [4]. Penthrox has been extensively used for many years by emergency medicine teams in Australia and New Zealand to provide rapid and effective pain relief to patients with trauma related injuries.

Conor Deasy, Consultant in Emergency Medicine, Cork University Hospital and Deputy Medical Director of the National Ambulance Service (IAEM) commented, “Treatments such as IV analgesia or gas and air can be cumbersome to set up and take time to administer. When reviewing the guidelines the PHECC committee is always looking to include new and innovative treatments, which have a proven benefit to patients and can directly improve the quality of service our emergency care teams can provide.

“Penthrox is easy to use and relieves moderate to severe pain quickly, allowing healthcare professionals to provide a more immediate and effective pain relief and a better patient experience.”

He concluded, “Availability of Penthrox in the Republic of Ireland and its inclusion on the new Pain Management Clinical Practice Guidelines is an important step forward towards achieving better acute pain relief for our patients.”

Professor Sir Keith Porter, Professor in Clinical Traumatology and Clinical Lead for Major Trauma, Queen Elizabeth Hospital, Birmingham, said: “I congratulate PHECC for taking the initiative with the provision of emergency pain relief of patients suffering moderate to severe trauma in the Republic of Ireland. Penthrox has an excellent safety profile and unlike many other analgesics it does not depress respiration, cause hypotension or alter level of consciousness. Its rapid onset and offset time makes it an ideal analgesic option for use in first patient contact, whether in pre-hospital care or by the triage nurse in Emergency Departments.”

While Dr Mark Forrest, a consultant in Anaesthesia & Critical Care and Clinical Director in Urgent and Emergency care in the UK, said: “Penthrox fills a very important gap in our management of moderate to severe pain, where cannulation has not yet been achieved or is impossible. The simplicity of use, the effectiveness and the safety make this an extremely useful option for providing high quality care at the earliest opportunity to our patients. I have been astounded how effective this agent can be, even during the extrication of casualties with serious trauma at road traffic collisions for example.”

Galen’s Managing Director, David Bennett, said: “We are delighted Penthrox is not only available to use in the Republic of Ireland, but has also been recognised as a crucial element of the PHECC pain ladder. At a time when emergency departments and ambulance teams are experiencing significant pressures, we are excited about the potential of Penthrox to improve service efficiencies as well as patient care.”


  1. Pre-Hospital Emergency Care Council, Clinical Practice Guidelines, Advanced Paramedics, 2017, 6th edition: (accessed March 2017)
  1. Pre-Hospital Emergency Care Council, Clinical Practice Guidelines, Paramedics, 2017, 6th edition: (accessed March 2017)
  1. Pre-Hospital Emergency Care Council, Clinical Practice Guidelines, Emergency Medical Technician, 2017, 6th edition: (accessed March 2017)
  1. Summary of Product Characteristics, Penthrox®  (accessed March 2017)
  1. Stop! Study: a randomised, double-blind, placebo-controlled study of the efficacy and safety of methoxyflurane for the treatment of acute pain. March 2017)