Cowan John D, Palmer Teresa W
Advanced Illness Assistance Team, Blount Memorial Hospital, 907 East Lamar Alexander Parkway, Maryville, TN 37804, USA.
Curr Oncol Rep. 2002 May;4(3):242-9. doi: 10.1007/s11912-002-0022-2.
Terminally ill patients want assurance that their symptoms will be controlled as death approaches. Most patients can have a peaceful death with standard palliative care. Some patients approaching death, however, have refractory symptoms such as pain, dyspnea, nausea, and agitated delirium. Palliative sedation (PS), the use of medications to induce sedation in order to control refractory symptoms near death, is a therapeutic option for these patients. The reported frequency of PS use varies greatly, ranging from 5% to 52% of the terminally ill. One concern with PS is its effect on survival. Data suggest that PS does not lead to immediate death, with the median time to death after initiating PS being greater than 1 to 5 days. A number of medications have been used for PS, but midazolam is most commonly reported. PS is distinct from euthanasia because the intent of PS is relief from suffering without death as a required outcome.
晚期绝症患者希望确保在临近死亡时其症状能够得到控制。大多数患者通过标准的姑息治疗可以安详离世。然而，一些临近死亡的患者会出现难治性症状，如疼痛、呼吸困难、恶心和躁动性谵妄。姑息性镇静（PS），即使用药物诱导镇静以控制临近死亡时的难治性症状，是这些患者的一种治疗选择。报道的PS使用频率差异很大，在晚期绝症患者中从5%到52%不等。对PS的一个担忧是其对生存的影响。数据表明PS不会导致立即死亡，开始PS治疗后到死亡的中位时间大于1至5天。已用于PS的药物有多种，但最常报道使用的是咪达唑仑。PS与安乐死不同，因为PS的目的是缓解痛苦，而不是以死亡作为必然结果。
