Morphine for Dyspnea in Patients with Cancer
Authors: Eduardo Bruera, Robin L. Fainsinger
Journal: Annals of Internal Medicine (1994)

Letters15 April 1994Morphine for Dyspnea in Patients with CancerSteven H. Krasnow, MD, Robert G. Wadleigh, MD, and Martin H. Cohen, MDSteven H. Krasnow, MDVeterans Affairs Medical Center; Washington, DC 20422Albert Einstein Medical Center; Philadelphia, PA 19141Search for more papers by this author, Robert G. Wadleigh, MDVeterans Affairs Medical Center; Washington, DC 20422Albert Einstein Medical Center; Philadelphia, PA 19141Search for more papers by this author, and Martin H. Cohen, MDVeterans Affairs Medical Center; Washington, DC 20422Albert Einstein Medical Center; Philadelphia, PA 19141Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-8-199404150-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We agree with Bruera and colleagues [1] that morphine alleviates dyspnea in patients with advanced cancer but are concerned about some of their findings and the study design. They detected no respiratory depression by pulse oximetry; however, most patients in our prospective trial of continuous-infusion morphine for dyspnea [2] showed progressive increases in Pco2 and decreases in blood pH during serial arterial blood gas determinations. Bruera and colleagues' patients scored a mean of 30 on a 100-point dyspnea scale, suggesting only moderate dyspnea, whereas most of our patients were severely dyspneic. Milder dyspnea probably implies less pulmonary ...References1. Bruera E, MacEachern T, Ripamonti C, Hanson J. Subcutaneous morphine for dyspnea in cancer patients. Ann Intern Med. 1993; 119:906-7. Google Scholar2. Cohen MH, Anderson AJ, Krasnow SH, Spagnolo SV, Citron ML, Payne M, et al. Continuous intravenous infusion of morphine for severe dyspnea. South Med J. 1991; 230:229-34. Google Scholar3. Briggs GG, Berman ML, Lange S, Riker J, Rettenmaier M, DiSaia P. Morphine: continuous intravenous infusion versus intramuscular injections for postoperative pain relief. Gynecol Oncol. 1985; 22:288-93. Google Scholar4. Portenoy RK, Moulin DE, Rogers A, Inturrisi CE, Foley KM. I.v. infusion of opioids for cancer pain: clinical review and guidelines for use. Cancer Treat Rep. 1986; 70:575-81. Google Scholar Author, Article, and Disclosure InformationAuthors: Steven H. Krasnow, MD; Robert G. Wadleigh, MD; Martin H. Cohen, MDAffiliations: Veterans Affairs Medical Center; Washington, DC 20422Albert Einstein Medical Center; Philadelphia, PA 19141 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byOpioids for the palliation of breathlessness in advanced disease and terminal illnessAdministration des médicaments par voie sous-cutanée en soins palliatifsOpioids for the palliation of breathlessness in advanced disease and terminal illness.Expression of Xfz3, a Xenopus frizzled family member, is restricted to the early nervous systemFritz: a secreted frizzled-related protein that inhibits Wnt activity 15 April 1994Volume 120, Issue 8Page: 692-693KeywordsAnxietyArterial blood gasBloodDyspneaMorphineNutritionPulse oximetryVentilators ePublished: 15 August 2000 Issue Published: 15 April 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...