Fentanyl treatment for end-of-life dyspnoea relief in advanced cancer patients

Abstract

Our preliminary data suggest that subcutaneous-endovenous fentanyl may be associated with dyspnoea relief in dying patients. Further research is needed to confirm these findings.

Palliative Care for Cancer Patients During the COVID-19 Pandemic, With Special Focus on Lung Cancer

“…Morphine has been proven to be an effective treatment for refractory breathlessness ( 30 , 31 ). The risk of a shortage of morphine existed, but other drugs are not effective [oxycodone ( 32 )], or only anecdotal proof of its effectiveness on dyspnea exists [fentanyl ( 33 , 34 )]. To guide physicians in the use of other opioids in the treatment of dyspnea, local guidelines rapidly changed, or expanded with recommendations in times of shortages.…”

Pharmacologic and Non-Pharmacologic Dyspnea Management in Advanced Cancer Patients

“…8,[14][15][16][17] For example, oxycodone and fentanyl are potential substitutes for morphine in the palliative treatment of dyspnea. [9][10][11][18][19][20][21][22][23] There are a variety of efficacious ways to administer opioids for breathlessness relief. Oral and parenteral opioid formulations are particularly successful in minimizing dyspnea.…”

“…9 Similarly, various formulations of fentanyl, including intravenous, subcutaneous, and fentanyl pectin nasal spray, and even prophylactic fentanyl for breakthrough and acute dyspnea have a growing confirmatory evidence-base. 10,11,19,20 Subheading of "Pharmacologic Management: Opioids": Route and Dose While physician-controlled therapies are operational, intravenous opioid patient-controlled therapies are practicable and effective as well. 24 Patient-modulated intravenous opioid administration may even provide patients with feelings of increased autonomy and control over their condition's management.…”

“…8,14-17 For example, oxycodone and fentanyl are potential substitutes for morphine in the palliative treatment of dyspnea. 9-11,18-23…”

“…9 Similarly, various formulations of fentanyl, including intravenous, subcutaneous, and fentanyl pectin nasal spray, and even prophylactic fentanyl for breakthrough and acute dyspnea have a growing confirmatory evidence-base. 10,11,19,20…”