A Quebec cohort describes how benzodiazepines were used alongside other medicines during continuous palliative sedation until death.
Investigators analyzed 1,005 reporting forms from hospitals and hospices between January 2016 and March 2022, representing about 12% of reported continuous palliative sedations in Quebec. Cancer accounted for 78% of diagnoses. Psychological or existential distress, respiratory distress, pain, and delirium were recorded indications, often in combination.
Midazolam was used in 69% of cases and lorazepam in 48%; methotrimeprazine was also common. These percentages overlap because regimens often contained multiple medicines. Median sedation duration was two days.
Forms described a peaceful death in 93% of cases, incomplete symptom relief in 6%, and complications in 1%. These are reported clinical outcomes in a convenience cohort. They do not compare benzodiazepines against an untreated group or establish the effect of one medicine on survival. Some forms were incomplete, and reporting accuracy was not independently reviewed within the study.
A medication concentration or administration entry in this setting needs its indication and goals of care. This cohort supports describing patterns of symptom-directed sedation. It cannot supply a universal dose threshold, determine causation of death in an individual, or replace the patient’s contemporaneous palliative care record.
Original analysis of the supplied journal article, identified as PMC12936155.