Efficacy and safety of deep, continuous palliative sedation at home: a retrospective, single-institution study

Abstract

Goals: The goal of this study is to evaluate the feasibility and efficacy of palliative sedation at home (PSH) to approach refractory symptoms in dying cancer patients.

Materials and methods: Charts of 121 patients, observed by "L'Aquila per la Vita" Home Care Unit, from August 2006 to May 2008, were reviewed. Sixteen patients out of 44 who died at home (36.4%) were sedated. Indication for sedation was agitated delirium in 13 patients and dyspnea in three patients. A multistep midazolam-based protocol was administered.

Results: In all patients, a deep, prolonged, continuous sedation was obtained. No treatment-related complications were registered.

Conclusion: A midazolam-based protocol for PSH is feasible and effective. Our results need to be confirmed by prospective, multicentric, controlled studies.