{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T07:52:32Z","timestamp":1782633152993,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T00:00:00Z","timestamp":1603843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective was to evaluate the effectiveness of methoxyflurane versus standard care for the initial management of severe pain among adult emergency department (ED) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This randomized parallel\u2010group open\u2010label phase IV trial of methoxyflurane was conducted in a tertiary hospital ED setting in Australia. Inclusion criteria required adult patients to have an initial pain score\u00a0\u2265\u00a08 on the 11\u2010point Numerical Rating Scale (NRS). Patients were randomized 1:1 to receive either inhaled methoxyflurane (3\u00a0mL) or standard analgesic treatment at ED triage. The primary outcome was the proportion of patients achieving clinically substantial pain reduction, defined as a\u00a0\u226550% drop in the pain score at 30\u00a0minutes. Secondary outcomes included the pain score at multiple time points (15, 30, 60, 90\u00a0minutes) and the difference in the proportion of patients achieving a &gt;2\u2010point reduction on the NRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 120 patients randomized and analyzed between September 4, 2019, and January 16, 2020. The primary outcome was achieved in six (10%) patients in the methoxyflurane arm and three (5%) in the standard care arm (p\u00a0=\u00a00.49). A higher proportion of patients in the methoxyflurane arm reported a &gt;2\u2010point drop on the NRS at all time points (17% vs. 5% at 15\u00a0minutes, 25% vs. 9% at 30\u00a0minutes, 30% vs. 10% at 60\u00a0minutes, and 33% vs. 13% at 90\u00a0minutes). Methoxyflurane use was also associated with lower median pain scores at all time points.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Initial management with inhaled methoxyflurane in the ED did not achieve the prespecified substantial reduction in pain, but was associated with clinically significant lower pain scores compared to standard therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14144","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T06:15:50Z","timestamp":1601360150000},"page":"164-171","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Rapid Administration of Methoxyflurane to Patients in the Emergency Department (RAMPED) Study: A Randomized Controlled Trial of Methoxyflurane Versus Standard Care"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6486-4738","authenticated-orcid":false,"given":"Lisa","family":"Brichko","sequence":"first","affiliation":[{"name":"From Emergency and Trauma Centre Alfred Health Melbourne Australia"},{"name":"School of Public Health &amp; 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