根据患者的要求进行深度连续镇静,直到在息治疗单位死亡:回顾性研究
Simon Prampart1, Jean Francois Huon2,3, Andre Colpaert1
1CHU de Nantes, Service de Soins Palliatifs et de Support, Nantes Université, Nantes, France.
BMJ supportive & palliative care
|September 11, 2023
概括
持续和深度镇静直到死亡 (CDSUD) 经常用于耐受性痛苦或停止生命支持. 这项研究描述了镇静剂的实践,指出米达佐拉姆作为一线药物,而普罗马和普罗波作为二线药物.
科学领域:
- 抚慰性护理医学 抚慰性护理医学
- 临床药理学 临床药理学
- 在生命末期的护理.
背景情况:
- 关于息治疗中持续和深度镇静直到死亡 (CDSUD) 实践的数据有限.
- 了解CDSUD对于管理难治性痛苦和终身护理决策至关重要.
研究的目的:
- 描述CDSUD在息治疗单位的实践.
- 评估CDSUD中使用的镇静剂治疗的持续时间和剂量.
- 分析启动CDSUD的原因,包括耐药性痛苦和停止维持生命治疗的请求.
主要方法:
- 缓和护理单位患者的回顾性观察性研究 (2020年1月至2021年12月).
- 收集了关于患者人口统计,镇静的原因,持续时间和镇静剂剂量的数据.
- 镇静剂治疗方案的分析,包括一线和二线药物.
主要成果:
- 42名患者接受了CDSUD;79%为难治性痛苦.
- 米达佐拉姆是主要的镇静剂;经常添加 хлорпромазин (79%) 和 пропофол (40%).
- 镇静剂的平均持续时间为37小时,具体的平均最大剂量为米达佐拉姆,普罗马和普罗波.
结论:
- 本研究提供了关于CDSUD实践的描述性数据.
- 突出了二线镇静剂的常见使用,如与米达佐拉姆和普罗马联合使用的普罗波.
- 为临床实践提供有关生命末期镇静剂管理的信息.
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