Journal of Pain and Symptom Management
Volume 30, Issue 6 , December 2005, Pages 570-577

http://www.mdlinx.com/readArticle.cfm?art_id=1447035
      
Copyright © 2005 U.S. Cancer Pain Relief Committee Published by Elsevier Inc.
Clinical Note

When Nothing Helps: Propofol as Sedative and Antiemetic in Palliative Cancer Care

Staffan Lundström MDCorresponding Author Contact Information, Ulla Zachrisson MD and Carl Johan Fürst MD, PhD

Palliative Care Services (S.L., U.Z., C.J.F.), Stockholms Sjukhem Foundation; and Department of Oncology-Pathology (S.L., C.J.F.), Karolinska Institutet, Stockholm, Sweden

Accepted 27 May 2005.  Available online 21 December 2005.


Abstract

Benzodiazepines, neuroleptics, and barbiturates are commonly used for sedation to achieve symptom control in end-of-life care. Propofol has several advantages over traditional sedating agents that would indicate its use in treatment-refractory situations. We report on the use of propofol in 35 patients. In 22 patients, propofol was used for palliative sedation when treatment with benzodiazepines had failed. The mean dose range during treatment was between 0.90 and 2.13 mg/kg/h. The effect was assessed as good or very good in 91% of the patients. Thirteen patients were treated with propofol due to intractable nausea and vomiting. The mean dose range during the infusion period was 0.67–1.01 mg/kg/h. The effect was judged as good or very good in 69% of the patients. Based on our experience, we propose clinical guidelines on the safe use of propofol in specialized palliative inpatient units.

Key Words: Propofol; sedative; sedation; antiemetic; nausea; vomiting; palliative care


Corresponding Author Contact InformationAddress reprint requests to: Staffan Lundström, MD, Stockholms Sjukhem Foundation, Mariebergsgatan 22, S-112 35 Stockholm, Sweden.