As per a study published in 'Journal of Vascular Surgery', Sevoflurane applied topically to painful wounds lead to a rapid, robust, and long-lasting analgesic effect, allowing for a high degree of wound debridement. There are limited topical analgesic options available for wound debridement. This study was aimed at deducing the efficacy of using topical sevoflurane as an analgesic for wound debridement. Following the approval by the institutional review board, the medical records were reviewed for those patients who were previously accepted to be treated using the off-label topical sevoflurane (1 mL/cm²) as an analgesic for sharp debridement of the painful wounds, as it was already approved by the institutional Pharmacy Regulatory Commission and Medical Management. As per this protocol, the pain scores were calculated using a numerical rating scale (from 0 to 10 points) over 10 hours. Wound debridement was executed after the routine procedures. The medical records obtained from 152 patients were reviewed. The baseline pain was severe (median, 7 points). After the application of topical sevoflurane, the analgesic effect was rapid (median pain score of 2 points at 5 minutes). Full debridement was feasible in most of the wounds (93%). The initial intense analgesic effect persisted for 30 minutes, and then it decreased gradually with time to nearly reach the baseline values after 10 hours. According to the patients, the analgesic effect lasted several hours (median, 9 hours) with a high overall satisfaction  (median of 8 points on a scale ranging from 0 – 10). Itching occurred in 52  patients (34%).

"Irrigating complicated wounds with liquid sevoflurane seems to be a viable current off-label alternative when dealing with painful wounds, it is especially helpful when the pain is refractory to the conventional analgesic treatments", suggested Martinez-Monsalve et al. (authors of the review).