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Palliative Care 2016
September 29-30, 2016
Volume 6 Issue 5(Suppl) J Palliat Care Med
ISSN: 2165-7386 JPCM, an open access journal
conferenceseries .com
September 29-30, 2016 Toronto, Canada
2nd Global Congress onHospice & Palliative Care
J Palliat Care Med 2016, 6:5(Suppl)
APPROACH AND MONITORING AT HOME ON PATIENTS WITH ANTREATED PAIN AND
INTRATHECAL PUMP IMPLANTATIONS IN PALLIATIVE CARES
Calle Cruz LFa
aSeville University, Spain
The intrathecal analgesy emerges as a therapeutical option to relieve the untreated pain when other treatments have failed, and
in cases with high opium doses presenting unacceptable secondary effects
OBJECTIVES: To analyze the viability of the home handling of patients with intratecales pumps by a team of palliative cares
supported at home
MATERIAL AND METHODOLOGY: Retrospective descriptive analysis of terminal patients with intratecales pumps
implanted to control the pain.
Variables analyzed: age, sex, pathology type, functional capacity, survival from the pump implantation, average stay, medication
received, recharged number, secondary effects, necessary doses, adjuvant treatment, hospital transfers avoided and place of
death.
RESULTS: 15 patients with advanced oncology illness is analyzed. Average age 60 (40-75). Males- 60 %. Colon neoplasia:
40 %, Lumb: 26.6 %. Others: 33.4 %. Average Barthel index 38 (10-65). Medium survival since the pump implantation to
the death.137,46 days (10-425). Medium home recharged 3,2 (1-14). No secondary effects were found. Medication used:
Morphine- mínimum dose 3,5 mg / 24 hours- 6,5 mcg / 24 h). Clonidina 0,4 % ( 75 mcg/24 h). Secondary effects: 80%
presented constipation but non of them was hospitalized by intestinal obstruction, 13,3 % showed high blood pressure, a 20
% used Ziconotide, and all of them showed symtoms of alteration on the behavior and alusinations. 60 % presented nausea
and one patient was hospitalized due to emesis. A 100 % needed a rescued treatment and the 93 % adyuvante medication for
its control (pregabalina, dexametasona, AINE, anxiolytic and antidepressant). A 53 % kept a treatment with opioides with
retarded liberation.
7 patients required hospitalization due to emetic syndrome, urinary sepsis, dyspnea, pain, catheter infection, badly function
of the pump and replacement. Death place, hospital 60 %, home 40 %. The 100 % required a progressive increase of opioids as
the illness progressed.
CONCLUSIONS: The intrathecal pumps management can be performed at home safely by advanced Palliative Cares Units
avoiding transfers to the hospital in 48 occasions to recharge the pumps. No problems were found in the recharges at home.
OPPONENTSAND PROPONENTS VIEWS REGARDING PALLIATIVE SEDATIONATENDOFLIFE
Majd awwadia
aHashimaite University School of nursing, Jordan
Palliative sedation is sedating a patient to the point of unconsciousness to relieve one or more symptoms, when all other possible
measurements have failure. Palliative sedation is chargedwith controversy since developed.The purpose of this position statement
paper is to support and discussing opponents and proponent's views comprehensively around palliative sedation in terminally ill
patients. The most important dispute was if palliative sedation hastens death or not, if it can be used as physician-assisted suicide, if
it legalized euthanasia and (or) if it violate patient's autonomy. The current authors are supporting palliative sedation with advanced
incurable patients in order to alleviate patients suffering, palliative sedation offer to terminally ill patient's comfortable experience
at end of life and allow them to die in peace. Palliative sedation should be encouraged to get health care facilities and legal support.