Hydromorphone for dyspnoea in terminally ill patients with cancer: case series.

BMJ Support Palliat Care

Department of Palliative Care, Kitano Hospital, Osaka, Japan.

Published: January 2024

Objective: Opioids can mitigate dyspnoea, but the efficacy of hydromorphone use for dyspnoea in patients with cancer is not well known.

Methods: Patients with cancers with more than mild dyspnoea treated with subcutaneous injection of hydromorphone between March 2020 and February 2022 at Kitano Hospital (Osaka, Japan) were reviewed retrospectively. Only patients who could self-report their symptoms ≥3 days after the start of hydromorphone therapy were included. Dyspnoea severity was rated on a five-point scale (0: 'not bothersome'; 1: 'mild'; 2: 'moderate'; 3: 'severe'; 4: 'overwhelming').

Results: Fifteen patients (2 with moderate, 12 with severe and 1 with overwhelming dyspnoea) were deemed eligible. The median interval from the start of hydromorphone initiation to death was 19 (IQR, 11-37) days. Thoracic drainage and palliative sedation after the start of hydromorphone therapy was undertaken in three and two patients, respectively. At 3 days, the median score of the Dyspnoea Rating Scale was improved significantly from 3 to 2 compared with that at baseline (p=0.0023). The intensity of dyspnoea was improved in 11 patients (73%). Opioid-related adverse events were not observed within 3 days.

Conclusions: Using hydromorphone for dyspnoea in patients with cancer seems to be appropriate if morphine use is contraindicated.

Download full-text PDF

Source
http://dx.doi.org/10.1136/spcare-2022-003923DOI Listing

Publication Analysis

Top Keywords

hydromorphone dyspnoea
12
patients cancer
12
start hydromorphone
12
patients
8
dyspnoea
8
dyspnoea patients
8
hydromorphone therapy
8
hydromorphone
7
dyspnoea terminally
4
terminally ill
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!