The Use of Intravenous Fentanyl for the Palliation of Refractory Dyspnea in an End-stage Heart Failure Patient with Renal Insufficiency

Abstract

Introduction: We report a case of dyspnea in the patient with end-stage heart failure with renal insufficiency, which was refractory and was successfully controlled with intravenous fentanyl. Case: The patient was a 76-year-old man with dilated cardiomyopathy who repeatedly had been in and out of the hospital. He was admitted to the hospital because of heart failure exacerbation and treated with all available heart failure therapies, but his dyspnea was refractory. We implemented the team-based palliative care intervention and used intravenous fentanyl as a substitute for morphine due to renal insufficiency. His dyspnea was relieved in dose-dependent without heart failure recovery. Conclusion: In this case, we used intravenous fentanyl to relieve dyspnea in patients with end-stage heart failure. Under careful observation, fentanyl may be used as an alternative drug to relieve dyspnea in patients with end-stage heart failure.