A review of 17 case studies compiled over a 14-year period
by two community-base2007-12-01 to sedate patients and improve symptom control during the final days and
hours of life.
Retrospective review of 100 patients admitted to a palliative
care unit during a 14-month period, where authors note that 16%
of these patients required palliative sedation.
Retrospective reviewer of the charts of 115 patients
dying in a hospital or hospice. Authors observed that 26% received palliative
sedation (31% at the hospice, 21% at the hospital). Of note in this review
was the lack of difference in total time of survival after admission
between sedated and nonsedated patients (18.6 vs 19.1 days, respectively).
A more recent review of palliative sedation utilized
an electronic database search between the years 1990 to 1999 that revealed
13 series and 14 case reports involving 342 patients; sedative pharmacotherapy
was used in 20%-30% of terminally ill patients.
Literature on the incidence and use of palliative sedation has been increasing
and, as a result, providing more visibility, interest, and data on sedation
at the end of life; however, once again, the importance of a universal definition
cannot be stressed enough. Indeed, until an accepted definition is adopted
by palliative care clinicians, analysis and interpretation of studies, as well
as clinical acceptance and use of palliative sedation, will remain wanting
by cautious and hesitant clinicians and family members.
