PALLIATIVE SEDATION: A NARRATIVE REVIEW

Abstract

INTRODUCTION Population aging in the world brings with it challenges related to managing the health of the population with Chronic Non-Communicable Diseases. We must live and die with dignity. The advancement of the disease process can cause refractory symptoms that cause physical, psychological and existential suffering. Faced with this problem, we find in Palliative Care ways to promote dignified care. Palliative Sedation (SP) is the use of sedative drugs in a monitored manner with the aim of alleviating refractory physical, spiritual and/or psychosocial symptoms in terminally ill patients with advanced illnesses. The goal is comfort and not shortening life. The objective of this work is to carry out a narrative review on the practice of palliative sedation. METHODOLOGY: This is a narrative review in the database of the Virtual Health Library and SciElo, using the Health Descriptors: Conscious Sedation, Palliative Care and Terminal Care and the Boolean operator And. Inclusion criteria: available in full, in English, Portuguese and Spanish. Exclusion: duplicates and publications older than 5 years. RESULTS: We selected 12 studies that were categorized. DISCUSSION: The authors unanimously recommend SP in the face of refractory symptoms, some suggest therapy in the face of existential suffering. Ethical issues are inherent to practice. Health professionals' perception of SP may be influenced by their personal experiences and religiosity, or they may even attribute SP to an “early departure”. The lack of knowledge regarding the indication and management of therapy appears as evidence. Concepts of light, deep, continuous and intermittent sedation are evidenced in the literature. The relevance of effective communication with the patient, family and healthcare team is an essential strategy. CONCLUSION: The topic requires further studies for evidence-based practice. The indication of therapy in the management of refractory symptoms, the need for effective communication in the process and safe management are evident.