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Sedation for Refractory Symptoms 

Sedation for Refractory Symptoms
Chapter:
Sedation for Refractory Symptoms
Author(s):

Patti Knight

, Laura A. Espinosa

, and Bonnie Freeman

DOI:
10.1093/med/9780190244286.003.0004
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date: 23 September 2019

Suffering at the end of life involves physical, psychological, social, and spiritual distress. In most situations, multidisciplinary palliative interventions provide effective comfort, but in some instances, suffering becomes refractory and intolerable. In these circumstances, palliative sedation may be necessary. Drugs most commonly used for palliative sedation are benzodiazepines, neuroleptics, barbiturates, and anesthetics. Midazolam is the most commonly used of these drugs. The drug and route chosen vary based on the route available, location of the patient, and cost, as well as the preference of the provider. Informed consent is obtained with the patient, if possible, or family members. A major role of the palliative care team is to assist families in making the transition in treatment goals from cure to comfort.

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