• Ferraz Gonçalves, Aida Cordero, Ana Almeida, Arlindo Cruz, Céu Rocha, Madalena Feio, Paula Silva, Salomé Barbas, and Sandra Neves.
• Unidade de Cuidados Paliativos, Instituto Português de Oncologia, 4200-072 Porto, Portugal. ferrazg@netcabo.pt
• Support Care Cancer. 2012 Dec 1;20(12):3123-7.

AimThe purpose of this study is to study the practice of sedation by Portuguese palliative care teams.MethodsThe teams included on the website of the Portuguese Association for Palliative Care were invited to participate. Data from all the patients sedated between April and June 2010 were recorded. Sedation was defined as the intentional administration of sedative drugs for symptom control, except insomnia, independently of the consciousness level reached.ResultsOf the 19 teams invited only 4 actually participated. During the study period, 181 patients were treated: 171 (94 %) were cancer patients and 10 non-cancer patients. Twenty-seven (16 %) patients were sedated: 13 intermittently, 11 continuously, and 3 intermittently at first then continuously. The rate of sedation varied substantially among the teams. Delirium was the most frequent reason for sedation. Midazolam was the drug used in most cases. In 21 cases of sedation, the decision was made unilaterally by the professionals; in 16 (76 %) of those, the situation was deemed to be emergent. From the patients on continuous sedation, 9 (64 %) patients maintained oxygen, 13 (93 %) hydration, and 6 (43 %) nutrition. Two patients who had undergone intermittent sedation were discharged home and one was transferred to another institution; the reason for sedation in the three cases was delirium.ConclusionThere is a substantial variation in the sedation rate among the teams. One of the most important aspects was the decision-making process which should be object of reflection and discussion in the teams.

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