title: Self-administered, inhaled methoxyflurane improves patient comfort during nasoduodenal intubation for computed tomography enteroclysis for suspected small bowel disease: a randomized, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  To determine the efficacy and safety of self-administered, inhaled analgesic, methoxyflurane, used to improve patient comfort during computed tomography enteroclysis (CTE).
  
  
  METHODS
  A randomized, double-blind, placebo-controlled trial was performed at two Australian hospitals (one tertiary referral public hospital and one private hospital). Patients were randomized to 3 ml methoxyflurane or saline (scented to maintain blindness) via hand-held inhaler. The main outcome measures were patient comfort during each stage of CTE and an overall rating as recorded by patients 1h post-procedure on a 10 cm visual analogue scale. Patient willingness to undergo repeat CTE, radiologist-rated ease of nasoduodenal intubation, and patient-rated ease of use of the inhaler were also assessed.
  
  
  RESULTS
  Sixty patients (mean age 45 years; 41 women) were enrolled; 30 received methoxyflurane and were well matched to 30 receiving placebo. Procedural success was 98%. The mean dose of methoxyflurane consumed was 0.9 ml (SD 0.5). Patient comfort during nasoduodenal intubation was better with methoxyflurane {5.0 [95% confidence intervals (CI) 4.0-6.0]} than with placebo [2.7 (95% CI 1.8-3.7); p=0.002, t-test), but there were no significant differences for comfort levels at other times or overall. The inhaler was easy to use, was well tolerated, and there were no episodes of oxygen desaturation, aspiration, or anaphylaxis.
  
  
  CONCLUSIONS
  Inhalational methoxyflurane safely improves patient comfort during nasoduodenal intubation, but does not improve overall procedure comfort.
authors.affiliation: Department of Gastroenterology and Hepatology, Box Hill Hospital, Melbourne, Australia. dralanmoss@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Moss
authors.forename: F J
authors.initials: FJ
authors.lastname: Parrish
authors.forename: P
authors.initials: P
authors.lastname: Naidoo
authors.forename: A
authors.initials: A
authors.lastname: Upton
authors.forename: H
authors.initials: H
authors.lastname: Prime
authors.forename: B
authors.initials: B
authors.lastname: Leaney
authors.forename: P R
authors.initials: PR
authors.lastname: Gibson
mesh_terms: D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D001315:Australia; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging*; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D007441:Intubation, Gastrointestinal / Q000379:methods* / Q000523:psychology; D008297:Male; D008733:Methoxyflurane / Q000008:administration & dosage*; D017060:Patient Satisfaction; D010919:Placebos; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed
chemical_list: D018685:Anesthetics, Inhalation; D010919:Placebos; D008733:Methoxyflurane