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Respiratory adverse effects of opioids for breathlessness: a systematic review and meta-analysis.

Verberkt CA, van den Beuken-van Everdingen MHJ, Schols JMGA, Datla S, Dirksen CD, Johnson MJ, van Kuijk SMJ, Wouters EFM, Janssen DJA

Eur Respir J. 2017 Nov 22;50(5).

The effect of opioids on respiration in patients with advanced disease and chronic breathlessness was systematically looked at and a meta-analysis performed. Sixty-seven studies were included in the systematic review and 19 trials in the meta-analysis. The analysis showed a statistically significant
increase in PaCO 2 of 0.27kPa, (which was not considered clinically important), a non-significant increase of end-tidal carbon dioxide tension and a decrease of the PaO 2. A weighted meta-analysis showed no significant effect of opioids on SaO 2 and respiratory rate. There was no effect from the different routes of opioid administration (p=0.538) and the number of opioid doses (p=0.165) from the meta-regression. Limitations of this study were the great heterogeneity of treatments and patient populations. The authors conclude that there is no evidence of respiratory adverse effects of opioids in patients with breathlessness.

Composed by Elaine Boland.