Sedación paliativa en el manejo de síntomas refractarios al final de la vida : experiencia en hospitalización de cuidados paliativos Solca Guayaquil de enero del 2021 a diciembre del 2023.

Abstract

INTRODUCTION: In medicine, palliative sedation is understood as the administration of appropriate medications to reduce the level of consciousness in patients with advanced diseases who are at the end of life and present refractory symptoms. OBJECTIVE: To analyze the efficacy of palliative sedation in controlling refractory symptoms in patients admitted to the palliative care area. METHODOLOGY: An observational, descriptive, retrospective, and cross-sectional study was carried out in the palliative care area of the Solca Guayaquil Hospital, between January 2021 and December 2023. Adult cancer patients who received palliative sedation for refractory symptoms at the end of life were included. Sociodemographic, clinical, and pharmacological data were collected through a review of medical records. RESULTS: A total of 121 patients receiving palliative sedation were analyzed. The gender distribution was: 79 female patients (65%) and 42 males (35%), with a mean age of 57 years. The most frequent refractory symptoms were dyspnea (55%), delirium (36%), and other less frequent symptoms such as bleeding, seizures, and pain. The induction dose of 5 mg of midazolam was the most used, and the standard maintenance dose was 12.5 mg at 12 hours, 25 mg at 24 hours, 50 mg at 48 hours, 72 hours, and more than 72 hours. Sedation was assessed using the 6-point Ramsay scale. The mean survival time from the start of sedation to death was between 24 and 48 hours. CONCLUSIONS: This study was able to determine the efficacy of palliative sedation by controlling refractory symptoms using the Ramsay scale.