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Early Studies

Year Reference Brief Summary

1990

 Ventafridda First to describe their experience with palliative sedation.They found that 52.5% of 120 terminally ill homebound patients required sedation to control “unendurable symptoms” during the last week of life.

1991

 Greene A review of 17 case studies compiled over a 14-year period by two community-base2007-12-01 to sedate patients and improve symptom control during the final days and hours of life.

1991

 Fainsinger Retrospective review of 100 patients admitted to a palliative care unit during a 14-month period, where authors note that 16% of these patients required palliative sedation.

1997

 Stone Retrospective reviewer of the charts of 115 patients dying in a hospital or hospice. Authors observed that 26% received palliative sedation (31% at the hospice, 21% at the hospital). Of note in this review was the lack of difference in total time of survival after admission between sedated and nonsedated patients (18.6 vs 19.1 days, respectively).

2001

 Cowan A more recent review of palliative sedation utilized an electronic database search between the years 1990 to 1999 that revealed 13 series and 14 case reports involving 342 patients; sedative pharmacotherapy was used in 20%-30% of terminally ill patients.

Literature on the incidence and use of palliative sedation has been increasing and, as a result, providing more visibility, interest, and data on sedation at the end of life; however, once again, the importance of a universal definition cannot be stressed enough. Indeed, until an accepted definition is adopted by palliative care clinicians, analysis and interpretation of studies, as well as clinical acceptance and use of palliative sedation, will remain wanting by cautious and hesitant clinicians and family members.

 
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