French legislation about sedation in palliative medicine evolved in 2016 with the introduction of a right to deep and continuous sedation, maintained until death. The objective was to describe midazolam sedation at the COL (Centre Oscar Lambret [Oscar Lambret Center], French regional center for cancer control), in order to establish a current overview before the final legislative changes. Descriptive, retrospective and single-center study, concerning major patients in palliative care hospitalized from 01/01/2014 to 12/31/2015, who had been sedated by midazolam. The proven sedations (explicitly named) and the probable sedations were distinguished. A total of 54 sedations were identified (48 proven, 6 probable). Refractory symptoms accounted for 48.1% of indications, complications with immediate risk of death 46.3%, existential suffering 5.6%. Titration was performed in 44.4% of cases. Sedation was continuous until death for 98.1% of the cases. Probable sedation had a higher failure rate than proven sedation. Significant differences existed for the palliative care unit compared to other units regarding information to the patient, their consent, anticipation, mention by correspondence and carrying out titrations. When patients had already been treated with midazolam, the induction doses, initial maintenance doses, and doses at the time of death were significantly higher. For those receiving opioids, the maintenance dose at the time of death was higher. No comparison found a difference in overall survival. After a sufficient follow-up has enabled teams to familiarize with this new legislation, reflection on sedation should be conducted to adapt to final recommendations.

中文翻译：

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姑息医学中的咪达​​唑仑镇静：法国癌症控制中心的回顾性研究。

法国关于姑息医学镇静的立法于 2016 年制定，引入了深度持续镇静的权利，并维持至死亡。目的是描述 COL（奥斯卡兰布雷特中心 [Oscar Lambret Center]，法国癌症控制区域中心）的咪达唑仑镇静作用，以便在最终立法变更之前建立当前的概述。描述性、回顾性、单中心研究，涉及 2014 年 1 月 1 日至 2015 年 12 月 31 日期间住院、接受咪达唑仑镇静的姑息治疗主要患者。已证实的镇静剂（明确命名）和可能的镇静剂被区分开来。总共确定了 54 种镇静剂（48 种已证实，6 种可能）。难治性症状占适应症的48.1%，具有直接死亡风险的并发症占46.3%，生存痛苦占5.6%。44.4% 的病例进行了滴定。98.1% 的病例持续镇静直至死亡。可能的镇静剂的失败率高于证实的镇静剂。与其他单位相比，姑息治疗单位在向患者提供的信息、患者的同意、预期、通信提及和进行滴定方面存在显着差异。当患者已经接受咪达唑仑治疗时，诱导剂量、初始维持剂量和死亡时的剂量显着较高。对于那些接受阿片类药物的患者，死亡时的维持剂量更高。没有比较发现总体生存率存在差异。在充分的后续行动使团队熟悉这项新立法后，应对镇静剂进行反思以适应最终建议。