Surges Séverine Marie, Brunsch Holger, Przyborek Marta, Jaspers Birgit, Radbruch Lukas
Klinik für Palliativmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
Bonner Netzwerk für Versorgungsforschung, Universität Bonn, Bonn, Deutschland.
Schmerz. 2024 Oct;38(5):365-373. doi: 10.1007/s00482-024-00825-x. Epub 2024 Sep 12.
Palliative sedation aims to relieve refractory suffering in patients with life-limiting disease. The 2009 framework on palliative sedation of the European Association for Palliative Care (EAPC) has recently been updated. Recommendations have also been formulated by the research group SedPall in Germany. This article describes the social and ethical complexity of decision-making and summarises the recommendations. Patient autonomy is emphasised. Refractoriness of the suffering should be determined jointly by physician and patient. Sedation should be proportional, that is to say, its form and duration should be adapted to the patient's individual situation. The decision on palliative sedation and that on hydration involve two separate decision-making processes. Midazolam should be used as first choice. Particular attention should be paid to the patient's relatives/significant others and the treating team.
姑息性镇静旨在缓解患有危及生命疾病患者的顽固性痛苦。欧洲姑息治疗协会（EAPC）2009年的姑息性镇静框架最近已更新。德国的SedPall研究小组也制定了相关建议。本文描述了决策过程中的社会和伦理复杂性，并总结了这些建议。强调了患者的自主权。痛苦的顽固性应由医生和患者共同确定。镇静应适度，也就是说，其形式和持续时间应根据患者的个体情况进行调整。关于姑息性镇静的决定和关于补液的决定涉及两个独立的决策过程。应首选咪达唑仑。应特别关注患者的亲属/重要他人以及治疗团队。
