Place of opiates in the treatment of dyspnea in palliative care

Palliative care is a multidisciplinary approach to improving the quality of life of patients and their families at all stages of a critical illness. This approach is accomplished by managing distressing symptoms such as pain and dyspnea. Refractory dyspnea is characterised by persistent respiratory difficulty at rest or with minimal effort despite optimal treatment of the underlying disease. The use of opioids has been well-documented in this context; however, hesitation persists when prescribing opioids in the terminal stages of the disease. This work describes the current evidence for the use of opioids for the treatment of dyspnea in palliative care, the protocols and routes of their administration. (C) 2020 Elsevier Masson SAS. All rights reserved.