KẾT QUẢ ĐIỀU TRỊ KHÓ THỞ Ở BỆNH NHÂN UNG THƯ GIAI ĐOẠN MUỘN BẰNG MORPHIN LIỀU THẤP TẠI BỆNH VIỆN HỮU NGHỊ ĐA KHOA NGHỆ AN

Abstract

Objective: Evaluation of the effectiveness of low-dose morphine in treating dyspnea in patients with terminal cancer. Subjects and methods: Cross-sectional descriptive study on 32 patients diagnosed with advanced cancer, with severe dyspnea symptoms and poor response to previous dyspnea treatments, from October 2023 to April 2024 at the Nghe An General Friendship Hospital. The severity of dyspnea and treatment effectiveness were assessed based on the NRS score, SpO2 index, and respiratory rate. Factors related to treatment outcomes and adverse effects of the regimen were recorded and analyzed. Results: The mean age of the study group was 69; men accounted for 81.3%. The ECOG 2-3 physical status index had a similar rate (50.0%). Primary lung cancer was predominant (62.5%). The most common cause of dyspnea was pneumonia (87.5%); followed by tumor compression (62.5) and Chronic Obstructive Pulmonary Disease -COPD (59.4%). After treatment, mean respiratory rate gradually decreased at each examination moment compared to the former examination moment, however, the statistically significant difference remained in the first 4 hours after treatment. The NRS score at all moment decreased statistically significantly compared to the previous examination moment. Chest retraction symptoms decreased significantly in severity at 15 minutes, 30 minutes, 1 hour, and 4 hours after treatment, the decrease was not significant at 24 hours when compared to the previous examination time point. The majority of adverse events (AEs) were in grade 1, no cases were grade 3 or higher; the most common AEs were constipation and vomiting/nausea. Conclusion: Low-dose morphine regiment is an effective palliative treatment for dyspnea in advanced cancer patients with severe persistent dyspnea.