title: When nothing helps: propofol as sedative and antiemetic in palliative cancer care.
abstract: Benzodiazepines, neuroleptics, and barbiturates are commonly used for sedation to achieve symptom control in end-of-life care. Propofol has several advantages over traditional sedating agents that would indicate its use in treatment-refractory situations. We report on the use of propofol in 35 patients. In 22 patients, propofol was used for palliative sedation when treatment with benzodiazepines had failed. The mean dose range during treatment was between 0.90 and 2.13 mg/kg/h. The effect was assessed as good or very good in 91% of the patients. Thirteen patients were treated with propofol due to intractable nausea and vomiting. The mean dose range during the infusion period was 0.67-1.01 mg/kg/h. The effect was judged as good or very good in 69% of the patients. Based on our experience, we propose clinical guidelines on the safe use of propofol in specialized palliative inpatient units.
authors.affiliation: Palliative Care Services, Stockholms Sjukhem Foundation, Stockholm, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Lundström
authors.forename: Ulla
authors.initials: U
authors.lastname: Zachrisson
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Fürst
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage; D015897:Comorbidity; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology* / Q000517:prevention & control*; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology*; D010146:Pain / Q000453:epidemiology* / Q000517:prevention & control*; D010166:Palliative Care / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D015742:Propofol / Q000008:administration & dosage*; D013548:Sweden / Q000453:epidemiology; D013727:Terminal Care / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D000932:Antiemetics; D006993:Hypnotics and Sedatives; D015742:Propofol