Pediatric palliative sedation therapy with propofol: recommendations based on experience in children with terminal cancer

Title

Pediatric palliative sedation therapy with propofol: recommendations based on experience in children with terminal cancer

Creator

Anghelescu DL; Hamilton H; Faughnan LG; Johnson LM; Baker JN

Publisher

Journal Of Palliative Medicine

Date

2012

Subject

Intervention; Interventions; KPM Briefings

Description

Abstract Background: The use of propofol for palliative sedation of children is not well documented. Objective: Here we describe our experience with the use of propofol palliative sedation therapy (PST) to alleviate intractable end-of-life suffering in three pediatric oncology patients, and propose an algorithm for the selection of such candidates for PST. Patients and Methods: We identified inpatients who had received propofol PST within 20 days of death at our institution between 2003 and 2010. Their medical records were reviewed for indicators of pain, suffering, and sedation from 48 hours before PST to the time of death. We also tabulated consumption of opioids and other symptom management medications, pain scores, and adverse events of propofol, and reviewed clinical notes for descriptors of suffering and/or palliation. Results: Three of 192 (1.6%) inpatients (aged 6-15 years) received propofol PST at the end of life. Consumption of opioids and other supportive medications decreased during PST in two cases. In the third case, pain scores remained high and sedation was the only effective comfort measure. Clinical notes suggested improved comfort and rest in all patients. Propofol infusions were continued until the time of death. Conclusions: Our experience demonstrates that propofol PST is a useful palliative option for pediatric patients experiencing intractable suffering at the end of life. We describe an algorithm that can be used to identify such children who are candidates for PST.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

1082-1090

Issue

10

Volume

15

Citation

Anghelescu DL; Hamilton H; Faughnan LG; Johnson LM; Baker JN, “Pediatric palliative sedation therapy with propofol: recommendations based on experience in children with terminal cancer,” Pediatric Palliative Care Library, accessed May 27, 2022, https://pedpalascnetlibrary.omeka.net/items/show/11466.

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