Terminal sedation in palliative medicine definition and review of the literature

This paper reviews the reported use of nonopioid medications for terminal s edation. To provide a summary of the available literature, an electronic da tabase search was performed. Thirteen series and 1 4 case reports were iden tified. Various symptoms, including agitation, Zn pain, and confusion, requ ired terminal sedation. Eleven drugs were used in 342 patients. Most patien ts were also treated with concurrent opioids and received terminal sedation in an inpatient hospice unit. Midazolam was the most common sedative emplo yed. A good response - defined as adequate sedation - ranged between 75% an d 100%. The median time to death following the introduction of terminal sed ation was greater than 1 day. No agent appears to have superior efficacy or limiting toxicity.