Academic Journal
Propofol for palliative sedation: A systematic review of clinical outcomes, safety, and ethical implications.
| Τίτλος: | Propofol for palliative sedation: A systematic review of clinical outcomes, safety, and ethical implications. |
|---|---|
| Συγγραφείς: | Almeida-Jardim L; Palliative Medicine Center, Faculty of Medicine, University of Lisbon, Lisboa, Portugal., Reis-Pina P; Palliative Medicine Center, Faculty of Medicine, University of Lisbon, Lisboa, Portugal.; Acute Palliative Care Inpatient Unit, Local Health Unit of Santa Maria, Lisboa, Portugal. |
| Πηγή: | Palliative medicine [Palliat Med] 2026 Oct; Vol. 40 (9), pp. 1302-1321. Date of Electronic Publication: 2026 Jul 31. |
| Τύπος έκδοσης: | Systematic Review; Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: SAGE Publications Country of Publication: England NLM ID: 8704926 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-030X (Electronic) Linking ISSN: 02692163 NLM ISO Abbreviation: Palliat Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: London : SAGE Publications Original Publication: London : New York, NY : Cambridge University Press, North American distributors, Edward Arnold ; c1987- |
| Ιατρικοί όροι (MeSH): | Propofol*/therapeutic use , Propofol*/adverse effects , Palliative Care*/methods , Palliative Care*/ethics , Hypnotics and Sedatives*/therapeutic use, Humans ; Female ; Adult ; Male |
| Περίληψη: | Background: Palliative sedation is used to relieve refractory suffering in terminally ill patients. Propofol, an intravenous anesthetic, may offer advantages due to its rapid onset and short half-life. Aim: To evaluate the role of propofol in palliative sedation, focusing on symptom control, sedation depth, survival time, safety, and ethical implications. Design: Systematic review registered in PROSPERO (CRD42025643575; February 6, 2025). Data Sources: Scopus, MEDLINE, and Web of Science were searched for English-language studies (2005-2024) on propofol use in adult terminally ill patients. Studies comparing propofol with other sedatives or non-sedated controls were included; those involving anesthetic or intensive care settings were excluded. Risk of bias and certainty of evidence were assessed. Results were synthesized narratively. Results: Ten non-randomized studies were included (observational, cross-sectional, cohort, case series, and before-and-after designs), mostly of moderate quality, conducted in Europe (n = 7) involving 4072 patients (28,3% received palliative sedation), mainly with cancer. Symptom control was reported in 73%-100% of cases, target sedation depth was achieved in 52%-100%, although outcome definitions and measurement methods varied. Survival ranged from 19 h to 38 days. Propofol was used alone (n = 4) or with other sedatives (n = 6). Respiratory depression was the main safety concern. Ethical issues included absence of explicit consent and rare reports of life-shortening intent. Conclusions: Propofol may be considered as a rescue option in selected refractory cases managed by experienced teams; however, given the low to very low certainty of available evidence, findings should be interpreted cautiously and supported by institutional protocols and further prospective research. |
| Competing Interests: | Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Contributed Indexing: | Keywords: deep sedation; ethics; medical; palliative care; patient safety; propofol; survival rate; symptom burden; terminal care |
| Substance Nomenclature: | YI7VU623SF (Propofol) 0 (Hypnotics and Sedatives) |
| Entry Date(s): | Date Created: 20260731 Date Completed: 20260927 Latest Revision: 20261009 |
| Update Code: | 20261009 |
| PubMed Central ID: | PMC13612869 |
| DOI: | 10.1177/02692163261465774 |
| PMID: | 42533745 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1477-030X |
|---|---|
| DOI: | 10.1177/02692163261465774 |