Opioids for palliation of refractory dyspnea in chronic obstructive pulmonary disease patients

Dyspnea, a distressing symptom, in chronic obstructive pulmonary disease patients is often unrelieved. The purpose of this article is to examine the efficacy of opioids administered orally, in nebulized form and other routes in dyspnea relief. Additionally, factors that inhibit the prescription of opioids and use of opioids are explored.

Although there are multiple case reports and case series, there is a paucity of well designed, prospective, randomized controlled trials with large enough number of chronic obstructive pulmonary disease patients. One review of randomized controlled trials and another randomized controlled trial found opioids effective in relieving dyspnea without causing major adverse effects.

Opioid is an effective palliative drug in chronic obstructive pulmonary disease patients with distressing dypnea that is refractory to standard modalities of treatment.