Sedation in specialized palliative care: A cross-sectional study.

Area of Science:

• Palliative Care Medicine
• Clinical Practice Research
• Pharmacology in End-of-Life Care

Background:

• Palliative sedation is a recognized clinical practice in Sweden for managing refractory symptoms.
• Current data on the frequency, decision-making, and medication use in palliative sedation in Sweden are limited.

Purpose of the Study:

• To investigate the current practices of palliative sedation within specialized palliative care units in Sweden.
• To determine the incidence, decision-making processes, medications used, and depth of sedation in palliative care.

Main Methods:

• A retrospective, cross-sectional study design was employed.
• Medical records of 690 consecutive deceased patients from 11 palliative care units in southern Sweden during 2016 were analyzed.
• Data collected included sedation status, decision-making, medications, and sedation depth.

Main Results:

• Palliative sedation was administered to 8% of patients, with midazolam being the most common medication (94%).
• Sedation rates were comparable between cancer and non-cancer patients.
• A significant discrepancy was observed between planned and achieved sedation depth, particularly when formal decisions were absent.

Conclusions:

• The incidence of palliative sedation in Swedish specialized palliative care is 8%, lower than international benchmarks but increased from previous assessments.
• The study highlights variability in decision-making and achieved sedation depth, underscoring the necessity for standardized guidelines.
• Further research into optimizing decision-making and ensuring appropriate sedation depth is warranted.