Effects of high dose opioids and sedatives on survival in terminally ill cancer patients

Title

Effects of high dose opioids and sedatives on survival in terminally ill cancer patients

Creator

Morita T; Tsunoda J; Inoue S; Chihara S

Publisher

Journal Of Pain And Symptom Management

Date

2001

Subject

Female; Humans; Male; Palliative Care; Aged; Middle Aged; Survival Analysis; Inpatients; Forecasting; Dose-Response Relationship; Drug; Neoplasms/drug therapy; Critical Illness/therapy; Hypnotics and Sedatives/administration & dosage/adverse effects/therapeutic use; Narcotics/administration & dosage/adverse effects/therapeutic use

Description

Concerns that high dose opioids and sedatives might shorten patient survival could contribute to insufficient symptom alleviation for terminally ill cancer patients. To examine the effects of opioids and sedatives prescribed in the final 48 hours on patient survival, a re-analysis of the prospectively collected data was performed on 209 hospice inpatients. Patient characteristics and clinical symptoms were prospectively recorded, and information about the use of opioids and sedatives in the last two days was collected by a chart review. Opioids were prescribed in 82% of the patients, with a median dose of 80 mg oral morphine equivalent (OME)/48 hours. Sixty percent received some sedative medications, mainly haloperidol (43% of total sample, 7.5 mg/48 hours), midazolam (23%, 23mg/48 hours), and hydroxyzine (15%, 50 mg/48 hours). There were no significant differences in survival between the patients who received different doses of opioids ( or =600 mg OME/48 hours) and of benzodiazepines (0, 1--59, and > or =60 mg parental midazolam equivalent/48 hours). Also, the survival of patients with haloperidol, hydroxyzine, and other sedative medications did not differ from those without. Furthermore, an addition of use of opioids and sedatives in the final 48 hours into the multiple regression model for survival prediction achieved no significant increase in predictability. In conclusion, opioids and sedatives used for symptom control in the last days are not associated with patient survival. They are safe and useful medications to palliate severe distress in the terminal stage of cancer when administered with a low initial dosage and adequate titration.
2001

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

282-289

Issue

4

Volume

21

Citation

Morita T; Tsunoda J; Inoue S; Chihara S, “Effects of high dose opioids and sedatives on survival in terminally ill cancer patients,” Pediatric Palliative Care Library, accessed September 27, 2021, https://pedpalascnetlibrary.omeka.net/items/show/12205.

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