Abstract
Background: Systemic morphine is recommended in patients with very severe COPD with persistent dyspnea. Effectiveness of inhaled opioids is however still a matter of controversy. Administering nebulized morphine by pneumodosimeter (PNEUMONEB®) assures particle deposition in the trachea and large bronchi where the majority of opioid receptors is located.
Aim of the study: The aim of the study is to assess whether it is possible to reduce dyspnea in patients with very severe COPD with nebulized morphine delivered by pneumodosimeter (PNEUMONEB®) and to define the dose needed to achieve that effect.
Methods: The study is a double-blind, randomized, placebo controlled, cross-over trial consisting of two consecutive cycles, each lasting 4 days. During each cycle different, randomized substance is administered: morphine or placebo. Both substances are delivered by the same method (PNEUMONEB®) and in the same, increasing dosage. The efficacy of the treatment was assessed by VAS and by Wilcock test. The primary outcome measure was reduction of dyspnea by 10-20 mm in VAS scale.
Results: Five patients completed the study protocol. No substantial side effects during morphine cycle were noted. All patients experienced significant dyspnea reduction, mostly at 3 mg dose of morphine. The mean decrease in VAS scale was 21,4 mm for morphine cycle compared to mean 8,9 mm for placebo cycle.
Conclusions: Since the interim analysis proved efficacy of nebulized morphine in reducing dyspnea in patients with very severe COPD, the study is continued.
- Copyright ©ERS 2015