Midazolam sedation in palliative medicine: ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Midazolam sedation in palliative medicine: retrospective study in a French center for cancer control.
Author(s) :
Gamblin, Vincent [Auteur]
Berry, Vincent [Auteur]
Tresch-Bruneel, Emmanuelle [Auteur]
Reich, Michel [Auteur]
Da Silva, Arlette [Auteur]
Villet, Stéphanie [Auteur]
Penel, Nicolas [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Prod'Homme, Chloe [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Berry, Vincent [Auteur]
Tresch-Bruneel, Emmanuelle [Auteur]
Reich, Michel [Auteur]
Da Silva, Arlette [Auteur]
Villet, Stéphanie [Auteur]
Penel, Nicolas [Auteur]

METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Prod'Homme, Chloe [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Journal title :
BMC Palliative Care
Abbreviated title :
BMC Palliat Care
Volume number :
19
Pages :
85
Publication date :
2020-06-27
ISSN :
1472-684X
English keyword(s) :
Sedation
Midazolam
Palliative care
Oncology
Midazolam
Palliative care
Oncology
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background
French legislation about sedation in palliative medicine evolved in 2016 with the introduction of a right to deep and continuous sedation, maintained until death. The objective was to describe midazolam sedation ...
Show more >Background French legislation about sedation in palliative medicine evolved in 2016 with the introduction of a right to deep and continuous sedation, maintained until death. The objective was to describe midazolam sedation at the COL (Centre Oscar Lambret [Oscar Lambret Center], French regional center for cancer control), in order to establish a current overview before the final legislative changes. Methods Descriptive, retrospective and single-center study, concerning major patients in palliative care hospitalized from 01/01/2014 to 12/31/2015, who had been sedated by midazolam. The proven sedations (explicitly named) and the probable sedations were distinguished. Results A total of 54 sedations were identified (48 proven, 6 probable). Refractory symptoms accounted for 48.1% of indications, complications with immediate risk of death 46.3%, existential suffering 5.6%. Titration was performed in 44.4% of cases. Sedation was continuous until death for 98.1% of the cases. Probable sedation had a higher failure rate than proven sedation. Significant differences existed for the palliative care unit compared to other units regarding information to the patient, their consent, anticipation, mention by correspondence and carrying out titrations. When patients had already been treated with midazolam, the induction doses, initial maintenance doses, and doses at the time of death were significantly higher. For those receiving opioids, the maintenance dose at the time of death was higher. No comparison found a difference in overall survival. Conclusions After a sufficient follow-up has enabled teams to familiarize with this new legislation, reflection on sedation should be conducted to adapt to final recommendations.Show less >
Show more >Background French legislation about sedation in palliative medicine evolved in 2016 with the introduction of a right to deep and continuous sedation, maintained until death. The objective was to describe midazolam sedation at the COL (Centre Oscar Lambret [Oscar Lambret Center], French regional center for cancer control), in order to establish a current overview before the final legislative changes. Methods Descriptive, retrospective and single-center study, concerning major patients in palliative care hospitalized from 01/01/2014 to 12/31/2015, who had been sedated by midazolam. The proven sedations (explicitly named) and the probable sedations were distinguished. Results A total of 54 sedations were identified (48 proven, 6 probable). Refractory symptoms accounted for 48.1% of indications, complications with immediate risk of death 46.3%, existential suffering 5.6%. Titration was performed in 44.4% of cases. Sedation was continuous until death for 98.1% of the cases. Probable sedation had a higher failure rate than proven sedation. Significant differences existed for the palliative care unit compared to other units regarding information to the patient, their consent, anticipation, mention by correspondence and carrying out titrations. When patients had already been treated with midazolam, the induction doses, initial maintenance doses, and doses at the time of death were significantly higher. For those receiving opioids, the maintenance dose at the time of death was higher. No comparison found a difference in overall survival. Conclusions After a sufficient follow-up has enabled teams to familiarize with this new legislation, reflection on sedation should be conducted to adapt to final recommendations.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Submission date :
2023-11-15T08:41:50Z
2023-12-20T09:46:43Z
2024-04-16T07:36:00Z
2023-12-20T09:46:43Z
2024-04-16T07:36:00Z
Files
- s12904-020-00592-3.pdf
- Non spécifié
- Open access
- Access the document