A randomised, double-blind, comparative clinical trial of the effectiveness and tolerability of fentanyl in continuous parenteral perfusion versus on-demand bolus of morphine for the treatment of refractory dyspnoea in patients hospitalised for acute dec

This study is investigating the best way to help people who are very breathless when they are in hospital because their heart failure has suddenly become worse. When someone has severe breathlessness, it can be very distressing. Doctors often use medicines like morphine to help, but this study is comparing two different strong pain-relieving medicines: fentanyl and morphine.

We want to see which one is more effective at making patients feel less breathless and which one causes fewer unwanted side effects. Fentanyl will be given continuously, meaning a steady, small dose will be given over time. Morphine will be given ‘on-demand’, which means a dose is given when the patient needs it. Patients will be asked to rate their breathlessness using simple number scales, so we can track how they feel over a few days: at the start, after 24 hours, after 48 hours, and after 72 hours.

The findings from this study will help doctors understand the best way to manage severe breathlessness in these situations, potentially improving how patients feel when they are very unwell in hospital. This is important research because making breathing easier significantly improves a patient's comfort and quality of life during a difficult time.