Clinica Somer, Calle 38 No. 54 a 35, Rionegro, Colombia.
Medicáncer, Carrera 51 D No. 67-60, Medellin, Colombia.
Support Care Cancer. 2018 Sep;26(9):3173-3180. doi: 10.1007/s00520-018-4164-7. Epub 2018 Mar 29.
To describe the practice of palliative sedation (PS) in patients with advanced cancer in a specialized palliative care (PC) unit in Colombia.
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.
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.
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.
描述在哥伦比亚一家专门的姑息治疗（PC）病房中，对晚期癌症患者进行姑息性镇静（PS）的实践。
这是一项描述性的前瞻性研究，纳入了 2015 年 1 月至 7 月期间在哥伦比亚某癌症研究所住院并接受 PS 的所有成年癌症患者。检查的变量包括诊断、身体功能、镇静开始时的症状、使用的药物和剂量，以及镇静的类型、水平和时间。采用描述性和相关性统计方法进行分析。
共纳入 66 例患者，其中 70%为女性。患者的平均年龄为 61 岁（范围为 24-87 岁），74%的 Karnofsky 指数（KI）小于或等于 50%。最常见的诊断是乳腺癌（22%），82%的患者有转移性癌症。姑息性镇静的发生率为 2%，最常见的提示症状是呼吸困难（59%）、谵妄（45%）和疼痛（32%）。所有患者均接受咪达唑仑镇静。镇静开始到结束的平均时间间隔为 44 小时。功能与镇静时间之间存在显著的负相关关系。
姑息性镇静是治疗导致痛苦的难治性症状的有效治疗选择。结果与国际报告和指南一致，表明 PS 是根据个体患者的需求量身定制的，同时保持了较高的科学标准，即使在 PC 发展的背景下也是如此。然而，鉴于 PS 在哥伦比亚的使用仍然较少，仍需要进一步制定策略并明确 PS 的使用指征。
