Use of oxygen and opioids in the palliation of dyspnoea in hypoxic and non-hypoxic palliative care patients: a prospective study.

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
Katri Elina ClemensEberhard Klaschik

Abstract

Dyspnoea is a complex experience of the body and the mind. Whereas the effects of opioids on dyspnoea in advanced disease have been the focus of studies for management of dyspnoea in palliative medicine, the role of oxygen is still unclear. The effects of symptomatic oxygen and opioid treatment on ventilation and palliation of dyspnoea in hypoxic (H) and non-hypoxic (NH) palliative care patients were assessed and compared. In a prospective, non-randomised study, 46 patients with mild to severe dyspnoea were included. Transcutaneous measurement (earlobe sensor) of carbon dioxide partial pressure (tcpaCO2), pulse oximetry oxygen saturation (SaO2) and pulse frequency (PF) were monitored with SenTec digital monitor. Compared was: baseline data of the continuously documented respiratory parameters for about 15 min in patients breathing room air at admission, 60 min during nasal O2 insufflation, and 30, 90 and 120 min after the first opioid application and without O2 insufflation. Whereas opioid application resulted in a significant decrease in the intensity of dyspnoea and respiratory rate, during the nasal O2 insufflation (4 l/min), there was no significant decrease in the intensity of dyspnoea neither in H (P = 0.564) nor in NH (P...Continue Reading

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