Royal Surrey wins awards for pain relief during brachytherapy

A collaboration between Royal Surrey County Hospital’s anaesthetic, oncology and radiotherapy teams to introduce the use of an inhaled painkiller for cancer patients has won two awards. Their use of Penthrox for cervical cancer patients is said to be a UK first and won top prize at the Association of Anaesthetists’ winter scientific meeting, as well as Acute Pain Initiative of the Year at the National Acute Pain Symposium.

Penthrox is an emergency pain relief inhaler traditionally used in the trust’s emergency department for trauma patients. During the COVID-19 pandemic, a conversation between consultant anaesthetist Dr Ben Morrison and his oncology colleagues sparked a new application for Penthrox. Previously, when patients received brachytherapy treatment, an anaesthetist gave a spinal block injection before the equipment needed for the treatment was inserted. At the end of treatment, the equipment was removed while the anaesthetic was still in place. During the pandemic, the brachytherapy team sought to reduce footfall in the hospital by delivering two treatments in one day, so patients had fewer visits to hospital. This meant that by the time the second treatment finished, a patient’s pain relief would be wearing off when equipment was removed, which could cause discomfort.

During the pandemic, the brachytherapy team sought to reduce footfall in the hospital by delivering two treatments in one day, so patients had fewer visits to hospital. This meant that by the time the second treatment finished, a patient’s pain relief would be wearing off when equipment was removed, which could cause discomfort.

Dr Morrison 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.”

The teams have since been contacted by trusts interested in the use of Penthrox for cancer patients. Discussions are also taking place about other possible applications. Consultant clinical oncologist Dr Alex Stewart said: “This is one of those situations where COVID-19 provided us with significant challenges but those challenges resulted in some fantastic, lasting innovations being introduced. The new use of Penthrox has worked really well and made a massive difference to our cervical cancer patients. They really like using it and it allows them to be comfortable and pain free.”

Picture: Consultant clinical oncologist Dr Alex Stewart and consultant anaesthetist Dr Ben Morrison.

Published on page 3 of the January 2023 issue of RAD Magazine.