Why the study?
Does high-dose oxycodone plus midazolam improve dyspnea in an older patient with end-stage heart failure and renal insufficiency?
Does high-dose oxycodone plus midazolam improve dyspnea in an older patient with end-stage heart failure and renal insufficiency?
High-dose continuous subcutaneous oxycodone combined with midazolam may be a safe and effective strategy for managing dyspnea in patients with end-stage heart failure and renal insufficiency.
May offer dyspnea relief option in end-stage HF with renal failure; hypothesis-generating, requires controlled trials before practice change.
INTRODUCTION: We herein report a case of dyspnea in an older patient with end-stage heart failure and renal insufficiency successfully controlled with high-dose oxycodone plus midazolam. CASE: A 91-year-old womam with end-stage heart failure due to severe aortic stenosis and complete atrio-ventricular block developed dyspnea. We used continuous oxycodone subcutaneous injection instead of morphine for dyspnea due to renal insufficiency. Oxycodone relieved her dyspnea in a dose-dependent manner without serious adverse events. We also carefully administered midazolam for the dyspnea as well. CONCLUSION: We used high-dose oxycodone plus midazolam to manage dyspnea in an older patient with end-stage heart failure and renal insufficiency. High-dose oxycodone with midazolam might be useful for treating dyspnea under careful observation.
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Konishi et al. (2023) studied this question.
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