Palliative Treatment of Dyspnea With Epidural Methadone in Advanced Emphysema

This study investigated whether epidural methadone perfusion at the thoracic level can mitigate dyspnea in patients with advanced emphysema.Open-label clinical trial without a control group.University hospital.The inclusion criteria were a diagnosis of emphysema, basal dyspnea index (Mahler scale)or = 3, FEV(1)or = 35%, and no indication for pneumoreduction or lung transplantation surgery.An epidural catheter was inserted at the thoracic level connected to a perfusion pump for administering methadone (6 mg/24 h). Assessments were made at baseline, 1 week, and 1 month after catheter insertion.Pulmonary function tests were performed, and determinations were made of arterial blood gas levels, …