Dosimetrically administered nebulized morphine for breathlessness in very severe chronic obstructive pulmonary disease: a randomized, controlled trial.

摘要: Systemic morphine has evidence to support its use for reducing breathlessness in patients with severe chronic obstructive pulmonary disease (COPD). The effectiveness of the nebulized route, however, not yet been confirmed. Recent studies have shown that opioid receptors are localized within epithelium human trachea and large bronchi, a target site dosimetric nebulizer. aim this study was compare any clinical or statistical differences intensity between 2.0% 0,9% NaCl very COPD. double-blind, controlled, cross-over trial. Participants received during two 4-day periods. Sequence periods randomized. primary outcome measure reduction now by ≥20 mm using 100 mm visual analogue scale (VAS) at baseline, 15, 30, 60, 120, 180 240 min after daily administration, normal activities. Ten 11 included completed protocol. All experienced clinically statistically significant (p < 0.0001) nebulization. Mean VAS changes 0.9% were 25.4 mm (standard deviation (SD): 9.0; median: 23,0; range: 14.0 41,5; confidence interval (CI): 95%) 6.3 mm (SD: 7.8; 6.8; −11,5 19,5; CI: 95%), respectively. No treatment emergent adverse effects noted. Our showed superiority dosimetrically administered compared breathlessness. This may achieved through morphine’s direct action on airways, although systemic effect from absorption lungs cannot be excluded. Retrospectively registered (07.03.2017), ISRCTN14865597