Sedation and analgesia in unconscious palliative care patients: can bispectral index monitoring add to our understanding?
To the best of our knowledge, our unit - the palliative care unit at the Port Kembla Hospital in Warrawong, New South Wales, Australia - is the only one currently evaluating the contribution that BIS-like technology makes to the management of unconscious palliative care patients. The study includes patients who become unconscious as a result of disease progression or palliative sedation. By analyzing BIS data and comparing them with results obtained using standard observational measures of sedation and comfort, we hope to determine the relative worth of subjective and objective assessments. If the BIS proves to be a reliable measure of sedation, there may be a role for it in end-of-life care - it could be used to ensure that end-of-life care practices are evidence-based and that they achieve their stated goals. In this paper, we present some preliminary observations of our first 17 subjects and highlight the implications these observations have for our study and others.