Covarrubias-Gómez Alfredo, López Collada-Estrada Maria
J Pain Palliat Care Pharmacother. 2017 Sep-Dec;31(3-4):190-194. doi: 10.1080/15360288.2017.1315476. Epub 2017 May 16.
Delirium is a common problem in terminally ill patients that is associated with significant distress and, hence, considered a palliative care emergency. The three subtypes of delirium are hyperactive, hypoactive, and mixed, depending on the level of psychomotor activity and arousal disturbance. When agitated delirium becomes refractory in the setting of imminent dying, the agitation may be so severe that palliative sedation (PS) is required. Palliative sedation involves the administration of sedative medications with the purpose of reducing level of consciousness for patients with refractory suffering in the setting of a terminal illness. Propofol is a sedative that has a short duration of action and a very rapid onset. These characteristics make it relatively easy to titrate. Reported doses range from 50 to 70 mg per hour. The authors present a case of antipsychotic-resistant agitated delirium treated with a propofol intravenous infusion.
谵妄是晚期患者的常见问题，会导致严重痛苦，因此被视为姑息治疗急症。根据精神运动活动水平和觉醒障碍程度，谵妄可分为三种亚型：多动型、少动型和混合型。当临终前激越性谵妄变得难以控制时，激越可能会非常严重，以至于需要进行姑息性镇静（PS）。姑息性镇静是指使用镇静药物，目的是降低终末期疾病中难治性痛苦患者的意识水平。丙泊酚是一种起效迅速、作用时间短的镇静剂。这些特性使其相对容易滴定剂量。报告的剂量范围为每小时50至70毫克。作者介绍了一例使用丙泊酚静脉输注治疗的抗精神病药物难治性激越性谵妄病例。
