The use of high-dose oxycodone with midazolam for dyspnea due to end-stage heart failure in an older patient with renal insufficiency

Abstract

Introduction: We herein report a case of dyspnea in an older patient with end-stage heart failure and renal insufficiency successfully controlled with high-dose oxycodone plus midazolam.

Case: A 91-year-old womam with end-stage heart failure due to severe aortic stenosis and complete atrio-ventricular block developed dyspnea. We used continuous oxycodone subcutaneous injection instead of morphine for dyspnea due to renal insufficiency. Oxycodone relieved her dyspnea in a dose-dependent manner without serious adverse events. We also carefully administered midazolam for the dyspnea as well.

Conclusion: We used high-dose oxycodone plus midazolam to manage dyspnea in an older patient with end-stage heart failure and renal insufficiency. High-dose oxycodone with midazolam might be useful for treating dyspnea under careful observation.