Opioids to be used as last option to control dyspnea in heart failure events

A new study published in Heart suggests that opioids may only be used as a very last resort in the event that all other methods have failed or in an emergency to treat dyspnea in heart failure (HF).

The majority of textbooks recommend the use of opioids to treat dyspnea caused by heart failure. Meta-analyses are sparse, nevertheless. So, this study was carried out by Jan Gaertner and colleagues to analyze the efficiency of opioids in treating dyspnea in heart failure patients as well as their negative effects.

Randomized controlled trials (RCTs) evaluating the effects of opioids on breathlessness (the primary outcome) in patients with HF were the subject of a systematic review. Quality of life (QoL), death, and adverse effects were significant secondary outcomes. In July 2021, searches were conducted on the Cochrane Central Registry of Controlled Trials, MEDLINE, and Embase. The Cochrane RoB 2 Tool and the Grading of Recommendations Assessment, Development and Evaluation criteria were used, respectively, to evaluate the risk of bias (RoB) and the certainty of the evidence. In all meta-analyses, the random-effects model served as the major analytical tool.