• Internal medicine · Jan 2016

    Continuous Intravenous Morphine Infusion for Severe Dyspnea in Terminally Ill Interstitial Pneumonia Patients.

    • Makiko Takeyasu, Atsushi Miyamoto, Daisuke Kato, Yui Takahashi, Kazumasa Ogawa, Kyoko Murase, Sayaka Mochizuki, Shigeo Hanada, Hironori Uruga, Hisashi Takaya, Nasa Morokawa, and Kazuma Kishi.
    • Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Japan.
    • Intern. Med. 2016 Jan 1; 55 (7): 725-9.

    ObjectiveThe aims of this study were to evaluate the efficacy and safety of continuous morphine infusion for dyspnea in patients with acute exacerbation (AE) of end-stage interstitial pneumonia (IP).MethodsWe conducted a retrospective study. Based on the subjective clinical effectiveness ratings of "good," "moderate," "poor," or "unknown," the efficacy of continuous morphine infusion treatment was evaluated as defined as symptom relief that was "good" or "moderate."PatientsThis study included 22 consecutive opioid-naïve patients who received continuous morphine infusion in the palliative treatment of dyspnea resulting from AE-IP.ResultsOf 22 patients, nine achieved good dyspnea relief, eight had moderate relief, four had a poor response and one response was "unknown" within 24 hours of starting morphine infusion. Using an operational definition of dyspnea relief that was rated "good" or "moderate," the efficacy rate of morphine was 77% (n=17). There was a significant change in the respiratory rate (25 respirations per minute at baseline vs. 17 respirations per minute after 12 hours, p=0.02), however, none of the patients studied had fewer than eight respirations per minute.ConclusionWe conclude that continuous morphine infusion is an effective and safe therapy for severe dyspnea in terminal AE-IP patients without any serious adverse events.

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