Page 26 - Palliative Care, Trials and COVID-19 Tribulations: First-hand experience shared by the experts at ground zero

Are Opioids and Sedatives Safe to Use in Severe COVID-19?

Now, after talking about breathlessness, cough and pain, you can see that Morphine and other
Opioids, as well as sedative medications are very important in the palliative management of
patients with severe COVID-19. So, these are the medications that would be useful in your
ward. Very often I think that clinicians might actually be concerned because patients with
severe COVID-19, they are hypoxic. Is it safe to use these medications in severe COVID-19?

So, extrapolating from data which we have in the palliative care setting, when they looked at
using these medications in patients with chronic lung disease, like COPD, interstitial lung
disease and others. They have concluded that low dose opioids at a dose of up to 30 mg/day,
does not increase the kind of complications and mortality in COPD patients even if they have
hypercapnia and interstitial lung disease.

The systematic reviews showed that there are no significant or clinically relevant respiratory
adverse effects of opioids for chronic breathlessness if we are managing patients
appropriately using low doses and titrating it according to the symptoms and need.