Palliative sedation of terminally ill patients.
Rev Bras Anestesiol. 2012 Jul;62(4):580-92.
Abstract
BACKGROUND AND OBJECTIVES:
Although
there is extensive discussion on the subject in medical literature,
most of the questions still unanswered due to the lack of clear
definitions and guidelines, in addition to a large number of
contradictions in literature. The aim of this review is to try to
determine the best form of sedation for patients with cancer.
CONTENT:
The
following data on sedation were collected: definitions,
classifications, major events and indication criteria, selection of
drugs used, drugs most used, doses and routes, duration of sedation,
nutritional support and hydration during sedation, and sedation at home.
CONCLUSIONS:
Although
in recent years palliative sedation is being considered a normal
medical practice, there are still many gaps in our current
understanding. There is no consensus about which are the standard drugs,
maintenance or not of food, fluid intake, and hydration. Moreover, there is no ethical clarification on possible life-shortening effects and decision-making process.
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