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Abstract：
Background: When the suffering of a terminally ill patient is intolerable and refractory, sedatives are sometimes used for symptom relief. Objective: To describe the main principles of revised Japanese clinical guidelines about palliative sedation therapy. Design: Consensus methods using the Delphi technique were used. Results: The main principles of the guidelines that were newly defined or developed are as follows: (1) palliative sedation was defined as \"administration of sedatives for the purpose of alleviating refractory suffering\" (excluding the aim of reducing patient consciousness); (2) palliative sedation was classified according to the method of administration of sedatives: respite sedation versus continuous sedation (including (continuous) proportional sedation and continuous deep sedation); (3) a description of state-of-the-art recommended treatments for difficult symptoms such as delirium, dyspnea, and pain before the symptom was determined as refractory was included; (4) the principle of proportionality was newly defined from an ethical point of view; and (5) families\' consent was regarded as being desirable (mandatory in the previous version). Conclusions: We described the main principles of revised Japanese clinical guidelines about palliative sedation therapy. Further consensus building is necessary.
摘要：
背景：当一个绝症患者的痛苦是无法忍受和难治的，镇静剂有时用于缓解症状。目的:介绍日本临床指南修订后姑息性镇静治疗的主要原则。设计：使用Delphi技术的共识方法。结果：新定义或制定的指南的主要原则如下：（1）姑息性镇静被定义为“以减轻难治性痛苦为目的的镇静剂”（不包括降低患者意识的目的）；（2）姑息性镇静根据镇静剂的给药方法进行分类：喘息性镇静与连续镇静（包括（连续）比例镇静和连续深度镇静）；（3）对这种困难症状的描述呼吸困难,并将症状确定为难治性之前的疼痛包括在内;(4)从伦理角度新定义了相称性原则;(5)家庭同意被认为是可取的(在先前版本中是强制性的).结论：我们描述了修订后的日本姑息镇静治疗临床指南的主要原则。进一步建立共识是必要的。
