Propofol in terminal care.
In advanced cancer patients close to death, delirium, multifocal myoclonus, and restlessness may occur. Multi-organ failure and related metabolic changes are mostly responsible for these symptoms. A pharmacologic approach to manage the delirium is necessary in the majority of cases. Benzodiazepines, neuroleptics, and barbiturates are the most common drugs used. In the case reported, propofol administered at very low doses provided good control of neuropsychiatric symptoms. After a loading dose of 20 mg, an infusion of 50-70 mg per hr was started. The patient died peacefully after 8 hr of propofol infusion, without requiring opioids. Propofol seems to be a promising drug in treating the terminal agitated state that can be associated with the dying process.
Mercadante
S
S
Department of Anesthesia and Intensive Care, Buccheri La Ferla Fatebenefratelli Hospital, SAMOT, Palermo, Italy.
De Conno
F
F
Ripamonti
C
C
D003693:Delirium / Q000188:drug therapy*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000188:drug therapy; D010166:Palliative Care; D015742:Propofol / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000473:pathology; D013727:Terminal Care
D006993:Hypnotics and Sedatives; D015742:Propofol