Lassen CL, Abel R, Eichler L, Zausig YA, Graf BM, Wiese CHR. [Perioperative care of palliative patients by the anesthetist : medical, psychosocial and ethical challenges].
Anaesthesist 2013;
62:597-608. [PMID:
23836144 DOI:
10.1007/s00101-013-2198-2]
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Abstract
Anesthetists will encounter palliative patients in the daily routine as palliative patients undergo operations and interventions as well, depending on the state of the disease. The first challenge for anesthetists will be to recognize the patient as being palliative. In the course of further treatment it will be necessary to address the specific problems of this patient group. Medical problems are optimized symptom control and the patient's pre-existing medication. In the psychosocial domain, good communication skills are expected of anesthetists, especially during the preoperative interview. Ethical conflicts exist with the decision-making process for surgery and the handling of perioperative do-not-resuscitate orders. This article addresses these areas of conflict and the aim is to enable anesthetists to provide the best possible perioperative care to this vulnerable patient group with the goal to maintain quality of life and keep postoperative recovery as short as possible.
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