Abstract

SORIANO GARCIA, Jorge Luis et al. Midazolam in the terminal palliative sedation in patients with cancer. Rev cubana med [online]. 2011, vol.50, n.4, pp. 359-375. ISSN 0034-7523.

Objective: To describe the use of midazolam in cancer patients during the last days of life, as part of an assistance strategy of terminal palliative sedation. Methods: A retrospective and descriptive study was conducted in 30 patients treated in the Oncology Service of the "Hermanos Ameijeiras" Clinical Surgical Hospital from August, 2007 to december, 2010 with a histological diagnosis of cancer and refractory symptoms in terminal stage of disease, aged ³ 18 and a life expentancy less than 2 weeks. Previously, the write informed consent was obtained from patient and/or relatives for the prescription of midazolam hydrochloride (10 mg). Doses, ways and routes of administration were variable and in dependence of severity of symptoms, experience of physician responsible of the case and preferences of patients and/or relatives. Results: Dyspnea and agitation were the more frequent refractory symptoms, whereas 12 patients showed two or more symptoms. The subcutaneous route was the more used and in more than 70% of patients the drug intermittent way of administration was the used one. Survival time, after the drug administration was of 56,7% at 48 h and 5 patients had a survival of 4 days. The dose rank used was that of 10-60 mg/d in the case of midazolam. The lowest doses were used when there was predominance of anxiety symptoms, less refractory symptoms, the subcutaneous route and home administration. Conclusions: The terminal palliative sedation using midazolam account for the clinical need of controlling a intolerable symptomatic situation with an effective response and its administration is safe. This is the first report on the use of a drug for terminal palliative sedation in cancer patients in our country.

Keywords : Palliative sedation; palliative cares; midazolam.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )