High-dose propofol drip for palliative sedation: a case report.

Area of Science:

• Palliative Care
• Pharmacology
• Symptom Management

Background:

• End-of-life care often involves managing symptoms like agitation and terminal restlessness.
• Benzodiazepines and typical antipsychotics are common first-line treatments.
• Alternative pharmacotherapy is needed when conventional options are contraindicated or ineffective.

Observation:

• A hospice patient with a history of polysubstance abuse presented with refractory agitation and terminal restlessness.
• Opioid and midazolam doses escalated rapidly without symptom control.
• Propofol was initiated as an alternative pharmacotherapy.

Findings:

• Propofol was successfully titrated to manage the patient's refractory agitation and terminal restlessness.
• This demonstrates propofol's potential as an alternative in challenging hospice cases.
• The sedative-hypnotic agent provided effective palliation where other drugs failed.

Implications:

• Propofol may be a valuable option for palliative care in refractory agitation and terminal restlessness.
• This case highlights the need for flexible pharmacotherapeutic approaches in end-of-life symptom management.
• Further research into propofol's role in palliative sedation is warranted.