Palliative sedation in advanced cancer patients hospitalized in a specialized palliative care unit.
PURPOSE
To describe the practice of palliative sedation (PS) in patients with advanced cancer in a specialized palliative care (PC) unit in Colombia.


METHODS
Descriptive prospective study including all adults with cancer hospitalized under PS in a cancer institute between January and July 2015 in Colombia. Variables examined were diagnosis, physical functioning, symptoms at the start of sedation, medications and dosages used, and type, level, and time of sedation. Descriptive and correlational statistics were obtained.


RESULTS
Sixty-six patients were included, 70% of which were women. The patients had an average age of 61 years (range 24-87), and 74% had a Karnofsky Index (KI) of 50% or less. The most frequent diagnosis was breast cancer (22%), and 82% had metastatic cancer. The prevalence of palliative sedation was 2% and the most common symptoms indicating it were dyspnea (59%), delirium (45%), and pain (32%). All patients received midazolam as a sedative. The average time between the interval start and culmination of sedation was 44 h. There was a significant and inverse relationship between functionality and time under sedation.


CONCLUSIONS
Palliative sedation is a valid therapeutic option for refractory symptoms causing suffering. The results correspond to international reports and guidelines, which suggests that PS is tailored to the needs of the individual patient while maintaining a high scientific standard, even in a context where PC is under development. However, further development of strategies and clear indications towards the use of PS in Colombia are needed, given its still scarce use.
['Parra Palacio|Santiago|S|', 'Giraldo Hoyos|Clara Elisa|CE|', 'Arias Rodríguez|Camilo|C|', 'Mejía Arrieta|Daniel|D|', 'Vargas Gómez|John Jairo|JJ|', 'Krikorian|Alicia|A|http://orcid.org/0000-0003-2118-5692']
D005260:Female D006801:Humans D006993:Hypnotics and Sedatives D008297:Male D008875:Middle Aged D009369:Neoplasms D010166:Palliative Care D011446:Prospective Studies D013727:Terminal Care
Cancer Palliative care Deep sedation Evaluation of symptoms Neoplasia Terminal care