“Green Whistle” for Children approved for emergency pain relief following clinical trial
“Green Whistle” for Children approved for emergency pain relief following clinical trial
Sept. 10, 2025
Research
- New research has found that methoxyflurane delivered by ‘green whistle’ (penthrox) provides rapid pain relief for children aged 6 years and older with acute trauma injuries
- Children who received methoxyflurane experienced a faster and greater reduction in pain
- Only 1 in 10 of those treated with methoxyflurane needed rescue pain medication, compared to 1 in 3 in the untreated group
A major international clinical trial, led in Ireland Children’s Health Ireland (CHI) by Prof. Michael Barrett, with Co-Investigator Dr. Carol Blackburn and Research Nurses Madeleine Niermeyer, Ellen Barry, and Rachel Gallagher, supported by the Emergency Department team, has found that methoxyflurane, delivered via the familiar “green whistle” (Penthrox), provides significant and rapid pain relief for children aged 6 years and older with acute trauma injuries.
The study, conducted through the CHI Clinical Research Centre, which is supported by the Health Research Board (HRB) and Children’s Health Foundation (CHF), marks a major step forward in emergency paediatric care.
The MAGPIE Trial (Methoxyflurane Analgesia in Paediatric Injury Emergency) evaluated the use of methoxyflurane in over 240 children aged 6 to under 18 years presenting with moderate or severe pain in emergency settings. The results are clear: children who received methoxyflurane experienced a faster and greater reduction in pain compared to those given a placebo treatment.
Children, in pain, described the pain relief while inhaling the green whistle. Importantly, only 1 in 10 of those treated with methoxyflurane needed rescue or extra pain medication, compared to 1 in 3 in the placebo group - highlighting its effectiveness as a first-line treatment in emergency care. While some mild side effects such as dizziness, euphoria, and altered taste were more common in the methoxyflurane group, these were expected, short-lived and well-tolerated.
“This is a real success story for emergency paediatric care. The success of the MAGPIE trial is a testament to the dedication and professionalism of clinical and research teams in CHI. It is great to see clinical departments incorporating trials into their daily workflow, driving improved outcomes for children every day.
The MAGPIE Trial was led by UK Chief Investigator Dr Stuart Hartshorn, at Birmingham Children’s Hospital, and conducted utilising the international Paediatric Emergency Research United Kingdom and Ireland (PERUKI) research network. It builds on previous adult trials and now confirms methoxyflurane’s effectiveness and safety for children in clinical settings.
The trial has now concluded, and its findings support wider paediatric adoption of methoxyflurane as part of standard pain relief protocols in emergency departments and pre-hospital settings.
“The success of the MAGPIE trial is a testament to the dedication and professionalism of our entire team in CHI. Delivering a randomised controlled trial for children in pain in a busy 24/7 paediatric emergency department is no small feat, balancing emergency care with rigorous research protocols, all while supporting children and families in distress. I’m incredibly proud of our staff, whose commitment to care made it possible to carry out this important study to the highest standard. The green whistle offers an option that can be delivered quickly, effectively addressing pain and improving the care experience for patients and their families. We are very proud to have been part of its approval.