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Pediatric palliative sedation therapy with propofol: recommendations based on experience in children with terminal

Doralina L Anghelescu1, Hunter Hamilton, Lane G Faughnan

  • 1Division of Anesthesiology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA. doralina.anghelescu@stjude.org

Journal of Palliative Medicine
|June 27, 2012
PubMed

Insights

Propofol palliative sedation therapy (PST) offers a valuable option for pediatric oncology patients with intractable end-of-life suffering. This study details its use and proposes an algorithm for patient selection.

Area of Science:

  • Pediatric oncology
  • Palliative care
  • Pharmacology

Background:

  • Palliative sedation therapy (PST) for children using propofol is not extensively documented.
  • Intractable end-of-life suffering in pediatric oncology patients requires effective management strategies.

Observation:

  • Three pediatric oncology patients (aged 6-15) received propofol PST within 20 days of death.
  • Medication consumption (opioids, supportive) decreased in two patients during PST.
  • One patient required sedation as the primary comfort measure due to persistent high pain scores.

Findings:

  • Propofol PST was successfully administered to pediatric patients with intractable end-of-life suffering.
  • Clinical notes indicated improved comfort and rest for all patients receiving propofol PST.
  • Propofol infusions were continued until the time of death in all observed cases.

Implications:

  • Propofol PST is a viable palliative option for pediatric patients facing intractable suffering.
  • An algorithm for selecting pediatric candidates for propofol PST is proposed.
  • This approach may improve end-of-life care in pediatric oncology.
Abstract

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