Kawabata, M., & Kaneishi, K. (2013). Continuous subcutaneous infusion of compound oxycodone for the relief of dyspnea in patients with terminally ill cancer: A retrospective study. The American Journal of Hospice & Palliative Care, 30, 305-311.

The objective of this study was to evaluate the efficacy of injectable form of oxycodone on pain and dyspnea in terminally ill patients with cancer.

• Medical records of patients who received continuous subcutaneous oxycodone for pain relief were analyzed. 
• Patients' verbal ratings that were documented were used for analysis. 
• Changes in ratings and use of rescue doses were analyzed.

• The study reported on a sample of 95 patients.
• The mean age was 71.7 years, with a range of 47–92 years.
• Of the sample, 56% were males and 44% were females.
• Tumor types varied; the most common were lung and colon.
• All patients were in inpatient hospice care.

This single-site study was conducted in an inpatient setting in Japan.

• Patients were receiving end-of-life care.
• The study has clinical applicability for palliative care.

The study was a retrospective, descriptive trial.

A three-point symptom severity verbal rating was used.

• The most frequent reason for initiating subcutaneous oxycodone was patient difficulty taking oral medication. 
• Duration of administration ranged from 2.08–111.2 days, with an average of 14.4 days. 
• Initial base dosages used ranged from 4.8–84.6 mg per day, and final base doses averaged 61.8 mg per day, with a range of 3.8–192 mg per day. 
• Most patients were previously receiving parenteral morphine, oral oxycodone, or transdermal fentanyl.
• Effect on pain was rated as moderate in 50% of patients and as high in 41.7%.
• Effect on dyspnea was moderate in 36.5% and high in 4.2%. 
• The most common side effect was drowsiness/somnolence.

Subcutaneous oxycodone administration was effective for reduction of pain and dyspnea in some patients.

• The study had a small sample size of less than 100 patients.
• The study had a risk of bias (no control group, no blinding, and no random assignment).
• Measurement validity/reliability is questionable.
• Data were extracted retrospectively from medical records.

• This study describes the experience of one group in using subcutaneous oxycodone in end-of-life palliative care. 
• The study has many limitations, so the strength of this evidence is low. 
• Subcutaneous oxycodone administration may be a useful alternative for pain and dyspnea management in some patients.