article
Morphine Eases Pain, Doesn't Shorten Life
Content provided by Reuters
Wednesday, April 11, 2007
NEW YORK (Reuters Health) - When given in the appropriate doses to
treat cancer pain, morphine will not hasten a patient's death by interfering
with his or her breathing, a new study shows. The findings contradict the
conventional wisdom--held by many medical professionals as well as lay
people--that giving dying patients opioids for pain can shorten their lives
by depressing their respiration. "It's in all the textbooks as something to
be aware of, but probably the risk has been exaggerated," Dr. Declan Walsh
of The Cleveland Clinic Foundation in Ohio, one of the study's authors, told
Reuters Health. "It's not that there isn't a risk, but that we've been
perhaps been overly concerned about it."
To investigate how morphine affects respiration when given to
terminally ill patients, Walsh and his team monitored breathing and vital
signs in 29 patients who had been admitted to the hospital for treatment of
poorly controlled cancer pain. He and his colleagues had previously
investigated respiration in cancer patients after the appropriate dosage of
morphine had been reached. In the current study, they looked at respiration
as the dosage was being adjusted.
They found no evidence for any respiratory depression in the patients,
all of whom maintained blood oxygen saturation levels of 92 percent or
greater throughout the study.
The findings show, Walsh said, that "morphine can be used safely even
in patients who are very ill to relieve pain, and that physicians need not
be as concerned about the use of the drug in that situation as we have been
traditionally taught. This is all contingent on morphine being prescribed
correctly."
Knowledge of how best to prescribe opioids has progressed considerably
over the past two decades, thanks largely to experience with patients rather
than controlled studies, he added.
"It's really how the drugs are used rather than any intrinsic problem
with the drug that's at issue here," Walsh said. "Good physician training
and good training of nursing personnel involved can really make a
difference."
In a commentary accompanying the study, Drs. Rob George of University
College London and Claud Regnard of St. Oswald's Hospice write: "We urge
those in the medical community to understand the facts about morphine and
other opioids - it's time to set the record straight. Doctors should feel
free to manage pain with doses adjusted to individual patients so that the
patients can be comfortable and be able to live with dignity until they
die."
SOURCE: Palliative Medicine, March 2007.
Content provided by Reuters
Wednesday, April 11, 2007
NEW YORK (Reuters Health) - When given in the appropriate doses to
treat cancer pain, morphine will not hasten a patient's death by interfering
with his or her breathing, a new study shows. The findings contradict the
conventional wisdom--held by many medical professionals as well as lay
people--that giving dying patients opioids for pain can shorten their lives
by depressing their respiration. "It's in all the textbooks as something to
be aware of, but probably the risk has been exaggerated," Dr. Declan Walsh
of The Cleveland Clinic Foundation in Ohio, one of the study's authors, told
Reuters Health. "It's not that there isn't a risk, but that we've been
perhaps been overly concerned about it."
To investigate how morphine affects respiration when given to
terminally ill patients, Walsh and his team monitored breathing and vital
signs in 29 patients who had been admitted to the hospital for treatment of
poorly controlled cancer pain. He and his colleagues had previously
investigated respiration in cancer patients after the appropriate dosage of
morphine had been reached. In the current study, they looked at respiration
as the dosage was being adjusted.
They found no evidence for any respiratory depression in the patients,
all of whom maintained blood oxygen saturation levels of 92 percent or
greater throughout the study.
The findings show, Walsh said, that "morphine can be used safely even
in patients who are very ill to relieve pain, and that physicians need not
be as concerned about the use of the drug in that situation as we have been
traditionally taught. This is all contingent on morphine being prescribed
correctly."
Knowledge of how best to prescribe opioids has progressed considerably
over the past two decades, thanks largely to experience with patients rather
than controlled studies, he added.
"It's really how the drugs are used rather than any intrinsic problem
with the drug that's at issue here," Walsh said. "Good physician training
and good training of nursing personnel involved can really make a
difference."
In a commentary accompanying the study, Drs. Rob George of University
College London and Claud Regnard of St. Oswald's Hospice write: "We urge
those in the medical community to understand the facts about morphine and
other opioids - it's time to set the record straight. Doctors should feel
free to manage pain with doses adjusted to individual patients so that the
patients can be comfortable and be able to live with dignity until they
die."
SOURCE: Palliative Medicine, March 2007.