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Review: oral or parenteral opioids alleviate dyspnoea in palliative care

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 QUESTION: Are opioids effective in the treatment of dyspnoea?

Data sources

Studies were identified by searching Medline (1966–1999), EMBASE/Excerpta Medica (1980–1999), CANCERLIT (1988–1999), CINAHL (1982–1999), the Cochrane Library, Dissertation Abstracts, and SIGLE; reviewing the reference lists of relevant studies, reviews, and book chapters; and contacting authors, other experts in the field, and palliative care organisations.

Study selection

Studies were selected if they were randomised, double blind, placebo controlled trials of any opioid to alleviate breathlessness in patients with dyspnoea.

Data extraction

Data were extracted by 2 independent reviewers on study quality (concealment, blinding, withdrawals, and dropouts), disease that causes dyspnoea, intervention (opioid used and dosage), study methods, and results. The main outcome measure was a subjective assessment of dyspnoea. In studies of patients at rest, the breathlessness measurement nearest to 1 hour …

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  • Sources of funding: Palliative Care Research Fund of the Royal Marsden Hospital and Sackler Foundation.

  • For correspondence: Dr A L Jennings, North London Hospice and Barnet and Chase Farm Hospitals, London, UK. ajennings{at}

  • Abstract and commentary also appear in ACP Journal Club. A modified version of this abstract also appears in Evidence-Based Nursing.