Sedação paliativa do paciente terminal

Fabíola Leite Nogueira; Rioko Kimiko Sakata

doi:10.1590/S0034-70942012000400012

Review Article

Sedação paliativa do paciente terminal

Palliative sedation of terminally ill patients

Fabíola Leite Nogueira; Rioko Kimiko Sakata

http://dx.doi.org/10.1590/S0034-70942012000400012 Braz J Anesthesiol, vol.62, n4, p.586-592, 2012

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Resumo

JUSTIFICATIVA E OBJETIVOS: Apesar da ampla discussão sobre o assunto na literatura médica, a maioria das questões continua não respondida devido à falta de definições e orientações claras, além do grande número de contradições na literatura. O objetivo desta revisão é tentar verificar a melhor forma de sedação dos pacientes com câncer. CONTEÚDO: Foram colhidos dados sobre sedação: definições, classificações, principais manifestações e critérios para indicação, seleção de medicamentos usados, os medicamentos mais empregados, doses e vias, duração da sedação, suporte nutricional e hidratação durante a sedação e sedação domiciliar. CONCLUSÕES: Apesar de nos últimos anos a sedação paliativa estar sendo considerada prática médica normal, ainda existem várias lacunas em nossa compreensão atual. Não existe consenso sobre quais os fármacos padrões, manutenção ou não de alimentação, ingestão de líquidos, e hidratação. Além disso, faltam esclarecimentos éticos sobre possíveis efeitos no encurtamento da vida, e o processo de tomada de decisão.

Palavras-chave

Assistência Paliativa, DOENÇAS, Câncer, SEDAÇÃO, Profunda

Abstract

BACKGROUND AND OBJECTIVES: Although there is extensive discussion on the subject in medical literature, most of the questions still unanswered due to the lack of clear definitions and guidelines, in addition to a large number of contradictions in literature. The aim of this review is to try to determine the best form of sedation for patients with cancer. CONTENT: The following data on sedation were collected: definitions, classifications, major events and indication criteria, selection of drugs used, drugs most used, doses and routes, duration of sedation, nutritional support and hydration during sedation, and sedation at home. CONCLUSIONS: Although in recent years palliative sedation is being considered a normal medical practice, there are still many gaps in our current understanding. There is no consensus about which are the standard drugs, maintenance or not of food, fluid intake, and hydration. Moreover, there is no ethical clarification on possible life-shortening effects and decision-making process.

Keywords

Deep Sedation, Neoplasms, Palliative Care

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Sedação paliativa do paciente terminal

Palliative sedation of terminally ill patients

Fabíola Leite Nogueira; Rioko Kimiko Sakata

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