Application of anesthetic premedication in palliative medicine

Paulina Prusator-Żędzian; Marta Jasiewicz; Urszula Kościuczuk; Juliusz Kosel; Przemyslaw Jasiewicz; Karolina Niedźwiecka; Julia Kondracka; Piotr Jakubów

doi:10.5114/pm.2021.107319

eISSN: 2081-2833
ISSN: 2081-0016

Medycyna Paliatywna/Palliative Medicine

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2/2021
vol. 13

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abstract:

Guidelines/recommendations

Application of anesthetic premedication in palliative medicine

Paulina Prusator-Żędzian

¹

,

Marta Jasiewicz

²

,

Urszula Kościuczuk

¹

,

Juliusz Kosel

¹

,

Przemyslaw Jasiewicz

²

,

Karolina Niedźwiecka

³

,

Julia Kondracka

⁴

,

Piotr Jakubów

^{1, 5}

Uniwersytet Medyczny w Białymstoku, Białystok, Polska
Oddział Kliniczny Anestezjologii i Intensywnej Terapii z Pododdziałem Kardioanestezjologii, Szpital Uniwersytecki nr 1 im. dr. Antoniego Jurasza, Bydgoszcz, Polska
Zakład Medycyny Paliatywnej, Uniwersytet Medyczny w Białymstoku, Białystok, Polska
Gdański Uniwersytet Medyczny, Gdańsk, Polska
Uniwersytecki Szpital Kliniczny w Białymstoku, Białystok, Polska

Medycyna Paliatywna 2021; 14(2): 51–62

DOI: https://doi.org/10.5114/pm.2021.107319

Online publish date: 2021/07/24

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The paper presents the possibilities of using pharmacotherapy premedication for treatments and procedures in palliative medicine. To describe and explain the problem; the question was asked whether premedication is used and recommended in patients in palliative medicine and what medications, if any, are currently used.

A systematic review of the available literature until 2021 from the databases of Polish- and English-language literature, including Pub-med, Medline, and Cochrane, was carried out searching for the keywords: premedication, palliative medicine treatments, perioperative standards. We found 116 works, which were selected in several stages of the review.

No guidelines were found in review studies regarding premedication recommendations in palliative medicine. There are 5 groups of clinical cases in which pharmacotherapy is used as premedication before procedures. These include anti-anxiety medications, pain relievers, gastrointestinal prophylaxis drugs, cardiovascular stabilizer drugs, and antibacterial drugs. Premedication of low-risk patients to elective 1-day procedures is not routinely recommended. In patients in the field of palliative medicine, pharmacotherapy is used before anaesthesia and before the painful procedures from various chemical groups. In most studies, benzodiazepines, including midazolam, as well as gabapentinoids and painkillers, are recommended drugs. A wide range of other medications is used for the premedication of patients in palliative medicine. Giving up premedication before painful procedures and surgery in the group of palliative medicine patients is not recommended. The benefits of premedication in the form of anxiolytic and analgesic effects outweigh the potential side effects of premedication drugs.

keywords:

Application of anesthetic premedication in palliative medicine

Paulina Prusator-Żędzian 1 , Marta Jasiewicz 2 , Urszula Kościuczuk 1 , Juliusz Kosel 1 , Przemyslaw Jasiewicz 2 , Karolina Niedźwiecka 3 , Julia Kondracka 4 , Piotr Jakubów 1, 5

premedication, gabapentinoids, benzodiazepines, perioperative palliative standards

Paulina Prusator-Żędzian

¹

,

Marta Jasiewicz

²

,

Urszula Kościuczuk

¹

,

Juliusz Kosel

¹

,

Przemyslaw Jasiewicz

²

,

Karolina Niedźwiecka

³

,

Julia Kondracka

⁴

,

Piotr Jakubów

^{1, 5}