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Year 2022
August 2022

[Journal article] Use of Phenobarbitone for Palliative Sedation in Dyspneic Crises Due to COVID-19 Pneumonia – A Case Series

26 Aug 2022

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

Summary points:

  1. 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.
  2. 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.
  3. 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.

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