Document Detail


Is there a higher risk of respiratory depression in opioid-naïve palliative care patients during symptomatic therapy of dyspnea with strong opioids?
MedLine Citation:
PMID:  18333735     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Dyspnea is a highly prevalent symptom in palliative care patients. Opioids are the first-line therapy for symptomatic relief of dyspnea. However, respiratory depression is still a feared side effect of therapy with WHO III opioids. The risk of respiratory depression in opioid-naïve patients and in patients pretreated with strong opioids during symptomatic therapy of dyspnea was investigated in palliative care patients. PATIENTS AND METHODS: Twenty-seven patients were included in a prospective, nonrandomized study. All patients suffered from moderate to severe dyspnea. Transcutaneous measurement (earlobe sensor) of carbon dioxide partial pressure (tcpaCO(2)), pulse oximetry oxygen saturation (SaO(2)), and pulse frequency (PF) were monitored with SenTec Digital Monitor (SenTec AG, Therwill, CH). The following monitoring data were compared: baseline recording for 15 minutes, and 30, 60, 90, and 120 minutes after opioid application. RESULTS: The data obtained with transcutaneous measurement showed that there were no significant differences between the groups of opioid-naïve patients and those pretreated with strong opioids with regard to tcpaCO(2) increase or SaO(2) decrease after the first opioid application. Neither SaO(2) decreased significantly nor tcpaCO(2) increased significantly after the initial opioid application, which means there was no opioid-induced respiratory depression. The first opioid application, however, resulted in a significant decrease in the intensity of dyspnea and respiratory rate. CONCLUSIONS: No higher risk of respiratory depression and increase in tcpaCO2 in opioid-naïve palliative care patients, compared to patients pretreated with strong opioids, during symptomatic therapy of dyspnea with strong opioids could be found.
Authors:
Katri Elina Clemens; Ines Quednau; Eberhard Klaschik
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of palliative medicine     Volume:  11     ISSN:  1096-6218     ISO Abbreviation:  J Palliat Med     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-12     Completed Date:  2008-07-02     Revised Date:  2008-11-07    
Medline Journal Info:
Nlm Unique ID:  9808462     Medline TA:  J Palliat Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  204-16     Citation Subset:  IM    
Affiliation:
Department of Science and Research for Palliative Medicine, University of Bonn, Bonn, Germany. katrina-elina.clemens@malteser.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Analgesics, Opioid / adverse effects*
Carbon Dioxide / metabolism
Drug Therapy / statistics & numerical data*
Dyspnea / drug therapy*,  epidemiology,  metabolism
Female
Humans
Male
Middle Aged
Narcotics / adverse effects*
Neoplasms / epidemiology
Oximetry
Oxygen / metabolism
Palliative Care / statistics & numerical data*
Prevalence
Prospective Studies
Respiratory Insufficiency / chemically induced*,  epidemiology*,  metabolism
Risk Factors
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Narcotics; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
J Palliat Med. 2008 Jul;11(6):822   [PMID:  18715170 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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