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31st May 2023 Surgery Outcomes

Green whistle relief for podiatry patients

Hospital bed patient stock

Podiatrists at Noarlunga Hospital will trial a new model of care for anxious patients, including children, to help them get rapid access to some minor surgical procedures.

The study is an Australian first, which allows public podiatry patients who experience needle-phobia or anxiety to access inhalable medicine, methoxyflurane, known as the ‘green whistle’ to enable the pain-free removal of an ingrown toenail.

Methoxyflurane has been available for use in private podiatry practice since 2010 and is now on the list of approved SA Health medicines for use for podiatry outpatients at Southern Adelaide Local Health Network (SALHN).

Previously, SALHN patients experiencing needle phobia or anxiety about the procedure would be required to have the procedure performed in theatre under general anaesthetic. This can result in increased use of healthcare resources and longer waiting times.

The ability to have their procedure performed at an outpatient clinic allows patients to potentially have their toenail surgery sooner, reducing the possibility of complications including infection and septicaemia.

Rapid access to these procedures will also potentially reduce hospital emergency department presentations and the demand burden on surgical waiting lists.

Led by SALHN Senior Podiatrist Endorsed for Scheduled Medicines and UniSA Masters student, Claire Huxtable, the study will evaluate the effectiveness of methoxyflurane in reducing anxiety and local anaesthetic injection pain, with the hope that it can be expanded to other podiatry departments across Australia.

Podiatrists at Noarlunga Hospital have been awarded a SALHN Enquiry Grant for the study, thanks to funding from  The Hospital Research Foundation Group and Flinders Foundation.

Half a dozen SALHN outpatients have now accessed the green whistle during toenail surgery at Noarlunga Hospital, with the first surgery using the medication taking place in August last year.

Ms Huxtable said the new model of care had been developed in response to a common concern from patients about anxiety relating to needles, injections and associated pain, which if not addressed, can impact negatively upon patient outcomes.

“Methoxyflurane can alleviate discomfort while the local anaesthetic is administered, providing a pain-free experience during minor surgery,” she said.

“We anticipate our research will show this model of care enables this group of patients to have toenail surgery sooner, with less sedation and a faster recovery. Thank you to the Flinders Foundation and The Hospital Research Foundation Group for making this research possible.”