Nebulized Fentanyl for Dyspnea: A Retrospective Chart Review

J Pain Palliat Care Pharmacother. 2020 Jun;34(2):77-81. doi: 10.1080/15360288.2019.1708529. Epub 2020 Jan 10.

Abstract

Nebulized fentanyl is well established for analgesia but its use for dyspnea requires further investigation. The aim of our study was to determine the effectiveness of nebulized fentanyl in treating patients with dyspnea and to determine if there were harmful side effects described by patients or their providers. We used a convenience sample of patients from July 1 2014 to July 1 2018 and performed a retrospective chart review. We found that 360 doses of nebulized fentanyl were given to 73 patients during that time period. Of the 73 patients evaluated, 32 patients (43.8%) were female and forty-one were male (56.1%). The median age was 67 and the median length of stay was 9 days. There were no documented findings of bronchospasm, hypotension, or allergic reaction in any of the medical records reviewed. Patients treated with nebulized fentanyl for dyspnea showed a mean decreased respiratory rate of 4.3 breaths/min and a mean increased oxygen saturation of 2.3%. Also, 71% of patients with documented responses experienced an improvement in their dyspnea. Our preliminary data suggest that nebulized fentanyl has limited side effects and may have a role in the treatment of dyspnea. Further research is necessary to determine its efficacy.

Keywords: Dyspnea; fentanyl; nebulized; opiod; palliative care.

MeSH terms

  • Administration, Inhalation
  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / therapeutic use
  • Dyspnea / drug therapy*
  • Female
  • Fentanyl / adverse effects
  • Fentanyl / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Nebulizers and Vaporizers*
  • Pain / drug therapy
  • Retrospective Studies

Substances

  • Analgesics, Opioid
  • Fentanyl