Nebulized Fentanyl for Dyspnea: A Retrospective Chart Review

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

Acknowledgements

This research received no specific funding/grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors have no conflicts of interest to declare. We wish to thank Jeni Hayes, PharmD, MSPharm, BCPS for her assistance in searching our electronic health record. We are also grateful to Hannah Coyne, Hannah Epstein and Conrad Williams for their expert review.