Ciais Jean François, Tremellat Flora, Castelli-Prieto Maud, Jestin Caroline
Department of Palliative Care, Centre Hospitalier de Nice , Nice, France .
J Palliat Med. 2017 Mar;20(3):282-284. doi: 10.1089/jpm.2016.0184. Epub 2016 Sep 27.
At the end of life, patients may feel refractory pain during care procedures although they receive appropriate analgesia. They can benefit from a short-term sedation. Propofol is used for procedural sedation in emergency or reanimation departments. It may be adapted in a palliative care unit.
The main objective was to verify whether propofol could allow us to administer care without causing major pain to patients with refractory pain at the end of life.
We conducted an open, prospective, and uncontrolled pilot study.
SETTING/SUBJECTS: The study was conducted in one palliative care center in France. The subjects were patients with an estimated prognosis less than three months who experienced pain during care procedures, although they receive appropriate analgesia.
Ten patients were included. Care was delivered with no major pain for 9 patients out of 10. The average duration of induction to reach deep sedation was 4 minutes (2-8) and of care procedures was 13 minutes (7-32). On average, the patient woke up 11.5 minutes after we stopped injecting propofol (7-18). Only one patient experienced a significant adverse effect caused by propofol, but it did not have any harmful consequence except the interruption of care procedures.
Transitory sedation using propofol for terminally ill patients hospitalized in a palliative care unit can offer optimal comfort during painful care procedures without significant complications. Patients woke up quickly. Further studies will have to be conducted to verify these initial results and make sure there are no major drawbacks.
在生命末期，尽管患者接受了适当的镇痛治疗，但在护理过程中仍可能感到顽固性疼痛。短期镇静可能对他们有益。丙泊酚用于急诊或复苏科室的程序性镇静。它也可在姑息治疗病房中应用。
主要目的是验证丙泊酚是否能使我们在为生命末期顽固性疼痛患者提供护理时不引起严重疼痛。
我们进行了一项开放、前瞻性且无对照的试点研究。
地点/受试者：该研究在法国的一个姑息治疗中心进行。受试者为预计预后少于三个月、在接受适当镇痛治疗的情况下仍在护理过程中经历疼痛的患者。
纳入了10名患者。10名患者中有9名在护理过程中未感到严重疼痛。达到深度镇静的平均诱导时间为4分钟（2 - 8分钟），护理过程的平均时间为13分钟（7 - 32分钟）。平均而言，在我们停止注射丙泊酚后11.5分钟（7 - 18分钟）患者苏醒。只有一名患者出现了由丙泊酚引起的显著不良反应，但除了护理过程中断外没有任何有害后果。
在姑息治疗病房住院的晚期患者中使用丙泊酚进行短暂镇静，可在疼痛护理过程中提供最佳舒适度，且无明显并发症。患者苏醒迅速。还需进一步研究以验证这些初步结果并确保没有重大弊端。
