Transdermal buprenorphine in the management of oncologic dyspnea in a patient with breast cancer

Abstract

This clinical case shows a successful example of the management of multifactorial oncologic dyspnea in a patient with advanced breast cancer being followed by the palliative care service at an institution in Bogota. The patient was diagnosed with advanced stage breast cancer, with metastatic involvement in lung parenchyma, lymphangitic carcinomatosis, bone, liver and central nervous system. During her outpatient controls she had poor tolerance to fast-acting opioids (morphine and hydromorphone), as they produced marked anxiety, tachycardia and diaphoresis. She presented exacerbation of dyspnea due to community-acquired pneumonia, so during his last hospitalization the cardinal symptom to be treated was oncologyc dyspnea. During her hospital stay, it was necessary to search for long-acting opioids that would produce minimal adverse effects, in order to achieve adequate adherence and efficient symptomatic control. To our knowledge, this would be the first reported case of symptomatic control of oncologic dyspnea with an opioid transdermal system with buprenorphine 35 mcg/h, in a patient with advanced stage breast cancer. © 2024 Sociedad de Anestesiologia de Chile. All rights reserved.