[Journal article] Use of Phenobarbitone for Palliative Sedation in Dyspneic Crises Due to COVID-19 Pneumonia – A Case Series
Authors: Jingwei Sim, Wen Yang Goh, Lynn Wiryasaputra, Allyn Yin-Mei Hum, Han Yee Neo, Choo Hwee Poi
Published in: Journal of Pain & Palliative Care Pharmacotherapy. Published online: 25 Aug 2022 DOI: 10.1080/15360288.2022.2113596
- Palliative sedation may be used in patients with severe COVID-19 pneumonia who are imminently dying, and who experience distressing dyspnea despite high doses of parenteral opioids and benzodiazepines.
- Factors that predict symptom burden at the end of life in COVID-19 patients are unclear. These may include nosocomial COVID-19 infection and prior opioid use.
- We describe for the first time the use of subcutaneous phenobarbitone for continuous sedation until death in two patients with COVID-19-related dyspnea. While phenobarbitone has a rapid onset, long half-life and anticonvulsive properties, the risk of paradoxical agitation warrants further investigation.