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Propofol-based palliative sedation in terminally ill children with solid tumors: A case series

Evelina Miele1, Mastronuzzi Angela1, M Giuseppina Cefalo1

  • 1Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS).

Medicine
|May 25, 2019
PubMed

Insights

Propofol effectively manages refractory symptoms in pediatric oncology patients undergoing palliative sedation. This study shows propofol, an anesthetic, is a tolerable option for end-of-life care in children with solid tumors.

Area of Science:

  • Oncology
  • Palliative Care
  • Pharmacology

Background:

  • Palliative sedation therapy involves reducing the alert state using pharmacological agents.
  • Propofol, a short-acting anesthetic, is rarely used in palliative care.
  • Managing refractory symptoms in terminally ill pediatric oncology patients is challenging.

Purpose of the Study:

  • To evaluate the quality and effectiveness of propofol-based palliative sedation.
  • To assess propofol as an adjuvant therapy for intractable suffering in pediatric oncology.
  • To determine the feasibility of propofol for end-of-life palliative sedation in children.

Main Methods:

  • A case series of 5 pediatric oncology inpatients with relapsed/refractory solid tumors.
  • Palliative sedation administered using propofol alone or in combination with opioids and benzodiazepines.
  • Evaluation of symptom control and patient outcomes.

Main Results:

  • Propofol-based palliative sedation effectively controlled refractory symptoms and psychological suffering.
  • Some patients reduced opioid consumption after initiating propofol.
  • Progressive sedation with propofol was the only effective measure for symptom control until death.

Conclusions:

  • Propofol is an effective and tolerable adjuvant drug for managing intractable suffering in pediatric oncology.
  • Propofol offers a practicable strategy for palliative sedation in end-of-life pediatric oncology care.
  • This approach aids in controlling refractory symptoms and psychological distress in terminally ill children.
Abstract

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