Backgroung and Aims: 5.6% of patients older than 65 years have chronic ulcers that cause pain and functional impotence, being venous ulcers the most frequent (80%).
Usually mechanical debridement is used to improve the healing process. Mechanical debridement is painful despite the use of systemic analgesics, thus requiring locoregional or general anesthesia.  EMLA cream has been used to reduce debridement pain, with poor results. Sevoflurane is an inhalational anesthetic with central action. Some evidence suggests it has peripheral analgesic action when administered topically. The aim was to study the analgesic efficacy of sevoflurane applied topically in painful chronic ulcers of different etiologies.
Methods: This prospective study included 22 patients with painful chronic ulcers that required debridement. Pain was assessed using a visual-analog scale (VAS: 0-10) at baseline and after applying sevoflurane (1 ml/cm2). The degree of satisfaction (Likert scale)  and complications were also assessed.
Results: 52.2% of patients were women. The mean age was 71.07 +/- 7.3 years. 30.45%  of ulcers were ischemic, 21.7% venous. 91.4% of ulcers were in lower limbs. Surface area mean was 22.5 +/- 11.1 cm2. The time of evolution (median) was 3.5 months. At baseline VAS was 7.8 +/- 0.6. 15 minutes, 60 minutes and 24 hours after applying sevoflurane VAS decreased to 3.6 +/- 0.8 (p <0.01), 2.7 +/- 0.9 and 2.8 +/- 0.7 (p < 0.01), respectively. The degree of satisfaction was high for all patients. No complications were manifest.
Conclusions: Topical sevoflurane provides effective and safe analgesia in chronic painful ulcers.

ANALGESIC EFFICACY OF TOPICAL SEVOFLURANE IN CHRONIC ULCERS OF DIFFERENT ETIOLOGIES