title: Intravenous Fentanyl for Dyspnea at the End of Life: Lessons for Future Research in Dyspnea.
abstract: OBJECTIVE
  To determine the efficacy of intravenous (IV) Fentanyl in dyspnoeic patients with advanced cancer.
  
  
  METHODS
  Dyspnoeic patients with advanced cancer satisfying the selection criteria received (IV) Fentanyl and were evaluated for response 24 hours post-administration in a prospective observational study.
  
  
  RESULTS
  Altogether 36 patients were enrolled into the study. However, data from only 16 patients could be analysed as 20 patients had died or were too sick to self-report scores. Seven out of 16 patients responded to IV Fentanyl although the result was not statistically significant (non-responders versus responders: 56.3% vs 43.8%, p = 0.33). The strongest correlations for variables predictive of responder status were the absence of anxiety and lung metastases.
  
  
  CONCLUSIONS
  This exploratory study shows that IV Fentanyl can alleviate dyspnea in some patients but is an example of the difficulties conducting dyspnea research. Future studies would benefit from novel developments in the areas of measuring dyspnea in dying patients and statistical analysis of small sample sizes.
authors.affiliation: Department of Palliative Medicine, National Cancer Centre Singapore, Singapore grace.pang.su.yin@nccs.com.sg.
authors.forename: G S
authors.initials: GS
authors.lastname: Pang
authors.affiliation: Department of Palliative Medicine, National Cancer Centre Singapore, Singapore.
authors.forename: L M
authors.initials: LM
authors.lastname: Qu
authors.affiliation: Department of Palliative Medicine, National Cancer Centre Singapore, Singapore.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Tan
authors.affiliation: Department of Palliative Medicine, National Cancer Centre Singapore, Singapore.
authors.forename: A C P
authors.initials: AC
authors.lastname: Yee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy / Q000209:etiology; D004417:Dyspnea / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000150:complications / Q000473:pathology; D011446:Prospective Studies; D013727:Terminal Care / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl
keywords: cancer; dyspnea; fentanyl; intravenous; lessons; opioid