Case Report

Patient and/or family controlled palliative sedation with midazolam for intractable symptom control: a case series

Diamanto Aretha¹ , Eleftheria S Panteli¹ , Panagiotis Kiekkas¹ and Menelaos Karanikolas²

¹  Department of Anaesthesiology and Critical Care Medicine, Patras University Hospital, Patras, Greece

²  School of Medicine, Department of Anaesthesiology and Critical Care Medicine, University of Patras, Patras, Greece

author email corresponding author email

Cases Journal 2009, 2:136doi:10.1186/1757-1626-2-136

Published:	11 February 2009

Abstract

Introduction

Our case series prospectively evaluate the concept of Patient/Family-Controlled Sedation with midazolam, as an alternative to sedation by continuous infusion in terminal cancer patients.

Cases presentation

Our method was applied in 8 pts. Midazolam was administered in a Patient Control Analgesia mode. The infusion pump was activated "as-needed" by the pt or a caretaker. Sedation was rated as: 1) awake 2) arousable to voice 3) arousable to light pain or 4) unarousable. Family satisfaction was rated as: 1) good, 2) fair, 3) poor, or 4) unacceptable. Mean midazolam consumption was 12 – 40 mg/24 hours. We did not observe respiratory depression. Death occurred 1–6 days after sedation started. Family satisfaction was mainly good and median sedation was in the range 2 – 3.

Conclusion

Patient/Family-Controlled Sedation with midazolam was effective in providing comfort, by allowing titration of sedation to each patient's needs.