Santiago Parra Palacio1, Clara Elisa Giraldo Hoyos2, Camilo Arias Rodríguez3, Daniel Mejía Arrieta3, John Jairo Vargas Gómez4,5, Alicia Krikorian6. 1. Clinica Somer, Calle 38 No. 54 a 35, Rionegro, Colombia. 2. Medicáncer, Carrera 51 D No. 67-60, Medellin, Colombia. 3. Faculty of Medicine, Universidad Pontificia Bolivariana, Campus de Robledo Calle 78b No. 72a-109, Medellin, Colombia. 4. Pain and Palliative Care Group, School of Health Sciences, Palliative Care Unit, Instituto de Cancerología, Clínica Las Américas, Universidad Pontificia Bolivariana, Campus de Robledo Calle 78b No. 72a-109, Medellin, Colombia. 5. Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Campus de Robledo Calle 78b No. 72a-109, Medellin, Colombia. 6. Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Campus de Robledo Calle 78b No. 72a-109, Medellin, Colombia. aliciakriko@gmail.com.
Abstract
PURPOSE: To describe the practice of palliative sedation (PS) in patients with advanced cancer in a specialized palliative care (PC) unit in Colombia. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
PURPOSE: To describe the practice of palliative sedation (PS) in patients with advanced cancer in a specialized palliative care (PC) unit in Colombia. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Entities:
Keywords:
Cancer; Deep sedation; Evaluation of symptoms; Neoplasia; Palliative care; Terminal care
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