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Revista Clínica de Medicina de Familia

On-line version ISSN 2386-8201Print version ISSN 1699-695X


ACEDO CLARO, Clementina  and  RODRIGUEZ MARTIN, Bárbara. Palliative sedation. Rev Clin Med Fam [online]. 2021, vol.14, n.2, pp.93-97.  Epub July 26, 2021. ISSN 2386-8201.

Many patients who are nearing the end-of-life suffer from intense anguish in terms of refractory symptoms, those that cannot be adequately controlled with the available treatments provided by expert doctors. Palliative sedation is the deliberate lowering of the patient’s depth of consciousness to avoid unbearable anguish caused by one or more refractory symptoms. It must meet multiple requirements to be considered an ethical and legal practice, such as the intent to relieve anguish, proper evaluation of the agony and the symptoms that cause it, the obtaining of informed consent and the use of the indicated drugs at the appropriate dose. Depending on the patient’s preferences, this can be performed either in an inpatient environment or at home, where the subcutaneous route is the method of choice. The first-line drug is midazolam, administered both intravenously and subcutaneously. If the patient experiences delirium as the primary symptom, levomepromazine will be administered. Sedation may be considered intermittently or continuously. It is essential to monitor the patient under sedation, both the depth of sedation acquired and the signs or symptoms of anguish, and to support the family.

Keywords : Hypnotics and Sedatives; Palliative Care; Palliative Sedation.

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