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晚期绝症患者的姑息性镇静

Palliative sedation of terminally ill patients.

作者信息

Nogueira Fabíola Leite, Sakata Rioko Kimiko

机构信息

Department of Anesthesiology, Pain and Intensive Care, Universidade Federal de São Paulo, SP, Brazil.

出版信息

Rev Bras Anestesiol. 2012 Jul;62(4):580-92. doi: 10.1016/S0034-7094(12)70157-5.

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.

摘要

背景与目的

尽管医学文献中对该主题有广泛讨论,但由于缺乏明确的定义和指南,以及文献中存在大量矛盾之处,大多数问题仍未得到解答。本综述的目的是试图确定癌症患者最佳的镇静方式。

内容

收集了以下关于镇静的资料:定义、分类、重大事件及指征标准、所用药物的选择、最常用的药物、剂量与途径、镇静持续时间、镇静期间的营养支持与补液,以及居家镇静。

结论

尽管近年来姑息性镇静被视为一种常规医疗行为,但我们目前的认识仍存在许多空白。对于哪些是标准药物、是否维持进食、液体摄入及补液,尚无共识。此外,对于可能的缩短生命效应和决策过程也没有伦理上的明确阐释。

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