The factual survey of using sedative agents in terminal cancer patients

Ahn, Mi Hong; Yeom, Chang Hwan; Lee, Hye Ree

Abstract

BACKGROUND: In terminal cancer patients, alleviation of suffering is as important as the cure of disease. But their symptoms are often intractable. In such a case, sedation is usually considered to relieve these refractory symptoms. However, the decision to sedate has been an ethical concern to health care workers because of an effect on survival time of cancer patients. The aim of this study was to investigate the use of sedation in terminal cancer patients and its relationship with intractable symptoms.
METHODS
One hundred and fifty six patients admitted to National Health Insurance Corporation Ilsan Hospital, Department of Family Medicine for hospice care from September 2000 to the end of October 2001 were enrolled in the study. Demographic data, clinical symptoms, the use of sedation, the choice of medication , reasons for administration, and frequency were recorded. RESULT: There were 81(51.9%) men and 75(48.1%) women. The mean age was 64.6+/-13.3 years. The primary sites of cancer were stomach 36(23.1%), lung 27(17.3%), and colo-rectal 19(12.2). Common symptoms were pain, nausea/vomiting, and dyspnea. Among the subjects 55(35.3%) received sedation. The drugs used for sedation were lorazepam in 37(67.3%), haloperidol in 21(38.2%), and diazepam in 18(32.7%). Sedation was administered to relieve insomnia in 20(36.4%), agitated delirium in 20(36.4%), severe pain in 9(16.4%), dyspnea in 5(8.0%), and nausea/vomiting in 1 (1.8%).
CONCLUSION
Among the subjects, 55(35.3%) of 156 terminal cancer patients received sedation. Though most common symptoms were pain and dyspnea, the use of sedation was mostly limited to insomnia and delirium. Therefore, the use of sedation is not yet prevalent in Korea.