Application of anesthetic premedication in palliative medicine

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.