Chronic Outpatient Treatment with Topical Sevoflurane in Patients with Vascular Ulcers.

Objective: To show the effectiveness and safety of topical sevoflurane after ambulatory and prolonged administration in patients with refractory vascular ulcers . Methods: Retrospective observational study analysing clinical improvement and vascular ulcers surface area variation after topical application of sevoflurane. Inclusion criteria were patients with painful vascular ulcers refractory to usual therapies and who were treated with topical sevoflurane for at least 36 months. The following variables were collected: age, sex, medical history, associated comorbidity, ulcer aetiology, and medical treatment. The visual analogue scale was used to measure baseline and break through pain intensity before and after treatment. Results: Nine patients met the inclusion criteria of the total number of patients treated whose median age was 74.8 +/- 7.5 years. Cases 2 and 9 died during follow-up. In all cases, the analgesic action of topical sevoflurane was rapid (3.1 +/- 2.1 min), intense (visual analogic scale: 7 +/- 1.1 to 1.4 +/- 1.1 points), and longlasting (6-24 h). With the exception of case 4, all patients experienced a large reduction in vascular ulcers surface area (15.1 +/- 5.0 to 2.7 +/- 4.2) and tolerance wasn't observed over time. Conclusion: Topical application of sevoflurane is an analgesic and re-epithelialising strategy for vascular ulcers with a successful safety profile. (c) 2023 Sociedad Espanola de Farmacia Hospitalaria (S.E.F.H). Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).