Uniformly defining continuous deep sedation
2016; Elsevier BV; Volume: 17; Issue: 3 Linguagem: Inglês
10.1016/s1470-2045(15)00585-9
ISSN1474-5488
AutoresMohamed Y. Rady, Joseph L. Verheijde,
Tópico(s)Epilepsy research and treatment
ResumoSedatives and hypnotics are used therapeutically to alter level of consciousness (responsiveness). The Richmond Agitation–Sedation Scale (RASS) is used to standardise the sedation level in response to sedatives and hypnotics. 1 Sessler CN Gosnell MS Grap MJ et al. The Richmond Agitation-Sedation Scale. Am J Respir Crit Care Med. 2002; 166: 1338-1344 Crossref PubMed Scopus (2208) Google Scholar The RASS is a numerical scale ranging from +4 to −5 (+4 for combative state and −5 for unarousable state with no response to voice or physical stimuli). Deep sedation corresponds to −4 on RASS, with no response to voice but movement in response to physical stimulation. RASS is useful in standardising the depth of sedation and titrating sedatives and hypnotics across study cohorts because of the varying pharmacokinetics and pharmacodynamics of these drugs in different patients. It is noteworthy that sedatives and hypnotics generally depress the level of consciousness but they do not necessarily abolish the content of consciousness or awareness of nociceptive stimuli. 2 Deschepper R Laureys S Hachimi-Idrissi S Poelaert J Bilsen J Palliative sedation: why we should be more concerned about the risks that patients experience an uncomfortable death. Pain. 2013; 154: 1505-1508 Summary Full Text Full Text PDF PubMed Scopus (55) Google Scholar Effect of continuous deep sedation on survival in patients with advanced cancer (J-Proval): a propensity score-weighted analysis of a prospective cohort studyCDS does not seem to be associated with a measurable shortening of life in patients with advanced cancer cared for by specialised palliative care services, and could be considered a viable option for palliative care in this setting. Full-Text PDF
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