Rapid Relief of Breathlessness With Fast-Acting Opioids and Benzodiazepines: A Systematic Review.
André Haubner, Adejoke O Oluyase, Irene J Higginson
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In 30 seconds
This systematic review evaluated the effectiveness and safety of fast-acting opioids and benzodiazepines for rapid relief of breathlessness in adults with advanced or severe acute disease. Eleven trials involving 334 participants were analyzed. Intravenous morphine demonstrated a mean difference of -1.8 cm in breathlessness relief compared to placebo, while subcutaneous morphine showed a mean difference of -1.1 cm.
Key findings
- Intravenous morphine provided a mean difference of -1.8 cm in breathlessness relief compared to placebo.
- Subcutaneous morphine showed a mean difference of -1.1 cm over placebo.
- No benefit was observed for inhaled opioids, intranasal fentanyl, or oral hydromorphone compared to placebo.
- Serious adverse events were more frequent in morphine treatment groups.
Why it matters
Understanding the effectiveness of fast-acting opioids and benzodiazepines for breathlessness can guide clinicians in managing acute symptoms in patients with severe disease, particularly when non-pharmacological measures are insufficient.
What to keep in mind
The review included mostly small crossover trials with varying methodologies and limited adverse-event monitoring.