© 2004 BMJ Publishing Group Ltd & British Thoracic Society
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The use of opioids for palliative care in refractory dyspnoea
Specialist Registrar in Respiratory Medicine, Chest Clinic C, Foresterhill, Aberdeen Royal Infirmary, Aberdeen, UK; graeme_currie@yahoo.com
| The first 150 words of the full text of this article appear below. |
Abernethy AP, Currow DC, Frith P, et al. Randomised, double blind, placebo controlled crossover trial of sustained releases morphine for the management of refractory dyspnoea. BMJ 2003;327:523–6
Dyspnoea is a disabling and distressing problem for many patients and carers. Clinicians are often reluctant to prescribe opioids for such patients because of concerns of adverse effects—particularly respiratory depression and sedation—and paucity of evidence of clinical benefit.
Abernethy and colleagues conducted a small (n = 48) double blind, placebo controlled, crossover study. Patients, most of whom had chronic obstructive pulmonary disease (n = 42), were randomised to receive 20 mg/day sustained release morphine or identical placebo. No washout period between the 4 day treatment periods was employed, although the authors acknowledge some carryover effect in patients receiving morphine first in sequence. Patients reported significantly less dyspnoea according to a visual analogue scale and had less sleep disturbance when using
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