From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Penthrane (methoxyflurane) is no longer recommended for routine use in children due to significant safety concerns, and alternative anesthetic agents such as sevoflurane should be considered instead. The evidence shows that methoxyflurane can cause dose-dependent renal failure through the production of inorganic fluoride and other metabolites 1, 2. While it was previously used as an inhalational anesthetic in pediatric patients from the 1960s through the early 1970s, it has been largely discontinued in most countries for general anesthesia due to its nephrotoxicity (kidney damage) and hepatotoxicity (liver damage).
Some key points to consider when evaluating the use of penthrane in children include:
- The potential for nephrotoxicity and hepatotoxicity, which can be severe and long-lasting 1, 2
- The availability of alternative anesthetic agents with better safety profiles, such as sevoflurane or desflurane 3, 4
- The importance of careful risk-benefit analysis and monitoring of renal function when considering the use of methoxyflurane in children 5
In some countries like Australia, a low-dose formulation called Penthrox is still available for short-term pain management in emergency settings, administered via a hand-held inhaler at doses much lower than previously used for general anesthesia 5. However, the use of penthrane in children should be approached with caution and only considered in exceptional circumstances, with careful monitoring of renal function and alternative anesthetic agents preferred.
The most recent and highest quality study on this topic is from 2020, which highlights the importance of early diagnosis and treatment of drug-induced nephrotoxicity 1, 2. This study emphasizes the need for careful consideration of the risks and benefits of using methoxyflurane in children, and the importance of monitoring renal function closely.
Overall, the use of alternative anesthetic agents such as sevoflurane is recommended for pediatric anesthesia due to their better safety profiles and lower risk of nephrotoxicity and hepatotoxicity 3, 4.