[Indications and use of benzodiazepines in a palliative care unit].
BACKGROUND
Benzodiazepines are often used in palliative care for symptom control, for example in treatment of dyspnea or anxiety. They are also used for palliative sedation, if symptoms are not controlled (fast) enough and a reduction of consciousness is therefore necessary. Incidence of palliative sedation has been reported to vary between 5-52% of all patients in a palliative care setting in several studies.


METHODS
Information from the records of 160 patients treated in the palliative care unit from September 2003 to December 2004 was evaluated from an electronic database. Gender, age, diagnosis, symptoms and medication, especially benzodiazepine dosage and application were analyzed.


RESULTS
Of the patients 70% were treated with benzodiazepines but only 3.1% received deep and continuous sedation. Benzodiazepines were applied as required in oral or sublingual form in 71.8% of all cases. Lorazepam was given most often because of anxiety and agitation, oxazepam to induce sleep and midazolam in five cases of terminal sedation. Only rarely were diazepam and clonazepam prescribed to prevent or resolve convulsions.


CONCLUSIONS
The majority of patients had been treated with benzodiazepines whereas only very few had received deep and continuous sedation.
Stiel
S
S
Klinik für Palliativmedizin, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland. sstiel@ukaachen.de
Krumm
N
N
Schroers
O
O
Radbruch
L
L
Elsner
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001569:Benzodiazepines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy*; D010148:Intractable Pain / Q000188:drug therapy*; D010166:Palliative Care; D012189:Retrospective Studies
D001569:Benzodiazepines; D008140:Lorazepam