PDF(Pubmed)
Abstract：
End-of-life delirium affects a vast majority of patients before death. It is highly distressing and often associated with restlessness or agitation. Unlike delirium in other settings, it is considered irreversible, and non-pharmacologic measures may be less feasible. The objective of this review is to provide an in-depth discussion of the clinical trials on delirium in the palliative care setting, with a particular focus on studies investigating pharmacologic interventions for end-of-life delirium. To date, only six randomized trials have examined pharmacologic options in palliative care populations, and only two have focused on end-of-life delirium. These studies suggest that neuroleptics and benzodiazepines may be beneficial for the control of the terminal restlessness or agitation associated with end-of-life delirium. However, existing studies have significant methodologic limitations. Further studies are needed to confirm these findings and examine novel therapeutic options to manage this distressing syndrome.
摘要：
临终谵妄影响绝大多数患者在死亡前。这是非常痛苦的，往往与不安或激动有关。与其他环境中的谵妄不同，它被认为是不可逆转的，和非药物措施可能不太可行。这篇综述的目的是对姑息治疗环境中谵妄的临床试验进行深入讨论，特别关注研究药物干预治疗临终谵妄的研究。迄今为止,只有六项随机试验研究了姑息治疗人群的药理学选择，只有两个人专注于临终谵妄。这些研究表明，精神安定药和苯并二氮卓类可能有助于控制与临终谵妄相关的终末躁动或躁动。然而,现有研究在方法学上有很大的局限性.需要进一步的研究来证实这些发现，并研究新的治疗方案来管理这种令人痛苦的综合征。
