Goals: The goal of this study is to evaluate the feasibility and efficacy of palliative sedation at home (PSH) to approach refractory symptoms in dying cancer patients.
Materials And Methods: Charts of 121 patients, observed by "L'Aquila per la Vita" Home Care Unit, from August 2006 to May 2008, were reviewed. Sixteen patients out of 44 who died at home (36.4%) were sedated. Indication for sedation was agitated delirium in 13 patients and dyspnea in three patients. A multistep midazolam-based protocol was administered.
Results: In all patients, a deep, prolonged, continuous sedation was obtained. No treatment-related complications were registered.
Conclusion: A midazolam-based protocol for PSH is feasible and effective. Our results need to be confirmed by prospective, multicentric, controlled studies.
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http://dx.doi.org/10.1007/s00520-009-0632-4 | DOI Listing |
BMJ Case Rep
January 2025
Maxillofacial Surgery, Waikato Hospital, Hamilton, New Zealand.
A man in his late 50s was referred by a speech and language therapist for consideration of a palatal lift prosthesis (PLP) to improve his speech intelligibility. He presented with hypokinetic dysarthria characterised by reduced loudness, breathy voice and hypernasality. The patient had a diagnosis of progressive muscular dystrophy and mobilised in a motorised wheelchair.
View Article and Find Full Text PDFPalliat Care Soc Pract
January 2025
Faculté des Sciences Infirmières, Université Laval, Québec, QC, Canada.
Background: Informed end-of-life decision-making requires a high level of death literacy. We still know little about the general population's level of knowledge and its determinants.
Aim: To assess knowledge of the general population regarding the legal status and definitions of various end-of-life practices, and to compare the level of knowledge according to individual characteristics known to influence death literacy.
Cancer
February 2025
Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer, Houston, Texas, USA.
Background: There is much concern that opioids administered as intravenous (iv) bolus for pain relief may inadvertently increase their risk for abuse. However, there is insufficient data to support this. The authors compared the abuse liability potential, analgesic efficacy, and adverse effect profile of fast (iv push) versus slow (iv piggyback) administration of iv hydromorphone among hospitalized patients requiring iv opioids for pain.
View Article and Find Full Text PDFCureus
January 2025
Anesthesiology and Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, NLD.
When a difficult airway is anticipated, awake tracheal intubation can be considered. Usually, low doses of sedatives are administered during this procedure for minimal sedation and anxiolysis, such as midazolam and remifentanil. The newly developed ultra-short-acting benzodiazepine remimazolam has a pharmacokinetic profile that is more suitable for titration during awake tracheal intubation than the long-acting midazolam.
View Article and Find Full Text PDFAm J Hosp Palliat Care
January 2025
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Objectives: To explore American Muslims' perceptions and experiences regarding hospice care within the United States.
Methods: A qualitative descriptive study of 11 participants, including one patient and ten family caregivers. Data was collected through semi-structured interviews and analyzed using a framework approach to identify key themes related to perceptions, ethical concerns, and experiences with hospice care.
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