Royal Surrey wins Acute Pain Initiative of the Year Award | News

A clever collaboration between Royal Surrey’s anaesthetic, oncology and radiotherapy teams, introducing the use of an inhaled painkiller for cancer patients, has won two prestigious awards. 

The teams’ innovative use of Penthrox® for cervix cancer patients is a UK first and won top prize at the Association of Anaesthetists’ Winter Scientific Meeting, as well as Acute Pain Initiative of the Year in the National Acute Pain Symposium.

Penthrox® (also known as the green whistle) is an emergency pain relief inhaler traditionally used in the Trust’s Emergency Department for trauma patients, such as those admitted with a broken leg.

During Covid-19, when the hospital faced unprecedented demands on staff time, a conversation between Consultant Anaesthetist Ben Morrison and oncology colleagues sparked a new application for the green whistle.

Prior to the pandemic, when patients received their brachytherapy treatment (where radioactive seeds are implanted in or near a tumour to treat cancer) an anaesthetist gave a spinal block injection before the equipment needed for the treatment was inserted. At the end of the treatment, the equipment was removed while the anaesthetic was still in place.

When the pandemic hit, the brachytherapy team looked at ways of reducing footfall in the hospital to protect patients from a risk of infection. They changed to delivering two treatments in one day, so patients had fewer visits to the hospital.

This meant that by the time their second treatment finished, a patient’s spinal block pain relief would be wearing off when equipment was removed, which could cause discomfort and pain.  

Ben said: “We came up with the idea of using Penthrox® at the end of the brachytherapy treatment, rather than having anaesthetists returning for a second spinal block.

“It proved to be a great success, delivering effective pain relief for the right amount of time and without anaesthetists being involved.

“Patients are able to control their level of pain relief by taking slow, deep breaths on the inhaler, so they feel reassured by it. It’s a simple but brilliant solution and has freed up precious time for the anaesthetic team.”

Penthrox® is popular with patients who have given extremely positive feedback, describing it as “better than a gin and tonic” and reporting zero or low pain scores.

Dr Alex Stewart, Consultant Clinical Oncologist said: “This is one of those situations where Covid provided us with significant challenges but those challenges resulted in some fantastic, lasting innovations being introduced.

“During a very difficult time in healthcare we did a lot of thinking outside of the box and we worked with colleagues around the Trust who were able to share skills from their areas.

“The new use of Penthrox® has worked really well and made a massive difference to our cervix cancer patients. They really like using it and it allows them to be comfortable and pain free. It’s also helped relieve some of the stress and anxiety they sometimes feel about having the procedure.”

Following their success winning the national and European awards for the project, the teams have been contacted by other Trusts interested in learning from the use of Penthrox® for cancer patients. Discussions are also taking place within the hospital about other possible applications for this method of pain relief.

Penthrox® is indicated for the emergency relief of moderate to severe pain in conscious adult patients with trauma and associated pain. The use of Penthrox® in brachytherapy would be outside the terms of the product’s licence, and any such use would be at the discretion of the prescriber.