OBJECTIVE: To measure changes in the practice of palliative sedation during agony in hospitalised elderly @entity1 before and after the implementation of a palliative sedation protocol. MATERIAL AND METHODS: A retrospective before-after study was performed in hospitalised @entity1 over 65 years old who received @entity1363 during hospital admission and died in the hospital in two 3-month periods, before and after the implementation of the protocol. Non-sedative uses of @entity1363 and @entity1 in intensive care were excluded. @entity1 and admission characteristics, the consent process, withdrawal of life-sustaining treatments, and the sedation process (refractory symptom treated, drug doses, assessment and use of other drugs) were recorded. Association was analysed using the Chi(2) and Student t tests. RESULTS: A total of 143 @entity1 were included, with no significant differences between groups in demographic characteristics or symptoms. Do not resuscitate (DNR) orders were recorded in approximately 70% of the subjects of each group, and informed consent for sedation was recorded in 91% before vs. 84% after the protocol. Induction and maintenance doses of @entity1363 followed protocol recommendations in 1.3% before vs 10.4% after the protocol was implemented (P=.02) and adequate rescue doses were used in 1.3% vs 11.9% respectively (P=.01). @entity1363 doses were significantly lower (9.86mg vs 18.67mg, P<.001) when the protocol was used than when it was not used. Ramsay sedation score was used in 8% vs. 12% and the Palliative Care Team was involved in 35.5% and 16.4% of the cases (P=.008) before and after the protocol, respectively. CONCLUSIONS: Use of @entity1363 slightly improved after the implementation of a hospital protocol on palliative sedation. The percentage of adequate sedations and the general process of sedation were mostly unchanged by the protocol. More education and further assessment is needed to gauge the effect of these measures in the future.

[Analysis of palliative sedation in hospitalised elderly XXXX : Effectiveness of a protocol].

@entity1 :: ('9606', 'Species') :: ['patients', 'Patient'] @entity1363 :: ('MESH:D008874', 'Chemical') :: ['Midazolam', 'midazolam']
@entity1 :: (9606,Species) :: ['patients']
