Rietjens, J.A., van Zuylen, L., van Veluw, H., van der Wijk, L., van der Heide, A., & van der Rijt, C.C. (2008). Palliative sedation in a specialized unit for acute palliative care in a cancer hospital: Comparing patients dying with and without palliative sedation. Journal of Pain and Symptom Management, 36(3), 228-234.
The primary aim of the study was to describe the practice of palliative sedation for patients with cancer and compare patients who were sedated prior to death with patients who were not sedated. The secondary aim was to explore clinical implications of palliative sedation for symptom management at the end of life.
The single-site study was conducted on an inpatient PCU in the Netherlands.
Patients were undergoing end-of-life and palliative care.
Retrospective, descriptive study
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Sixty-eight patients (43%) had received palliative sedation. Palliative sedation for the majority of patients (68%) started on the last day before death, with an average duration of 19 hours (range of 1–125 hours). No difference was seen between sedated and nonsedated patients with regards to sex or survival after admission to the acute PCU (mean of 8 and 7 days respectively, P = 0.12). Within 48–25 hours prior to death, sedation was initiated in 13 patients, while 45 patients received sedation 24–0 hours before death. The experience of pain, dyspnea, and delirium during the interval 48–25 hours before death in both sedated and nonsedated groups had decreased during the interval 24–0 hours before death (P = 0.54). Midazolam, sometimes combined with propofol, was the most commonly used sedating drug.