Abstract：
Palliative Sedation (PS) is an effective measure for the relief of refractory symptoms in end-of-life patients. This intervention can be performed at home, respecting the patients\' and their families\' decisions. A scoping review was performed to map the available evidence in the literature on the performance of PS at home. This review included 23 studies. Most were conducted in European countries with adult cancer patients. Patients, family members and healthcare providers participated in the decision making regarding the use of PS at home. PS was used primarily to manage refractory symptoms (pain, delirium, dyspnea, and others), and in 1 of the studies PS was mentioned as a possible intervention for shortening life. The most commonly used medication was midazolam and the average duration ranged from 4 h to 7 days. There are few reports on adverse events related to PS. This intervention seems to be a feasible possibility for the management of refractory symptoms in patients at the end of life, despite the fact that it can represent specific challenges for healthcare providers, patients and families. However, the literature is limited regarding PS in children and in people with diseases other than cancer, as well as on the evaluation of possible adverse effects related to this intervention. Furthermore, it is essential to have a broad ethical, clinical and legal debate on whether to consider the use of PS for the purpose of shortening life in specific cases.
摘要：
姑息镇静（PS）是缓解终末期患者难治性症状的有效措施。这种干预可以在家里进行，尊重病人和他们的家人的决定。进行了范围审查，以绘制文献中有关家庭PS表现的可用证据。这篇综述包括23项研究。大多数是在有成年癌症患者的欧洲国家进行的。患者,家庭成员和医疗保健提供者参与了有关在家中使用PS的决策.PS主要用于治疗难治性症状(疼痛，谵妄,呼吸困难,和其他)，在1项研究中，PS被认为是缩短寿命的可能干预措施。最常用的药物是咪达唑仑，平均持续时间为4小时至7天。很少有关于PS相关不良事件的报道。这种干预似乎是治疗患者生命末期难治性症状的可行可能性，尽管它可以代表医疗保健提供者的具体挑战，患者和家属。然而,关于儿童和患有癌症以外疾病的人的PS的文献有限，以及与该干预措施相关的可能不良反应的评估。此外，有广泛的道德是至关重要的，关于在特定情况下是否考虑使用PS来缩短寿命的临床和法律辩论。
