Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / natural molecules found in essential oils, Geraniol is one that has been extensively studied. The literature shows geraniol as an anti-inflammatory, chemo-preventive, antimicrobial, antioxidant, and neuro-protective agent. However, a lack of studies remains in covering the influence of this compound on the central nervous system. This study aimed to characterize the effect of geraniol in brainwave patterns, motor and anxiety-like behavior in Wistar rats. In the experiments, we used one hundred and eighty (180) male Wistar rats, all of them aged 3 and 4 months, from the Central Biotery and Neurophysiology Laboratory Biotery, both of Federal University of Sergipe. Behavioral tests were performed to evaluate engine components and anxiety (perforated plate and open field). We also evaluated barbiturate-induced sleeping time. We performed Electrocorticogram (ECoG) exams to characterize the pattern of brain waves. We used three different doses of geraniol in the tests: 25, 50 and 100 mg/kg. Divergences in the literature regarding the anxiolytic dose of diazepam as control in the hole-board and open field test led us to carry out a dose-response curve to determinate such dose, followed by a comparison with doses of geraniol. In the hole-board we observed that the dose of 2,0 mg/kg Diazepam increased immobility time and decreased the number and duration of rearing. There was a large increase in head-dipping time in animals treated with diazepam 0,5 mg/kg. As to the open field test, Diazepam at a dose of 5,0 mg / kg decreased distance traveled and the animals treated with this dose remained most of the time immobile. The number and duration of rearing were higher in animals treated with diazepam at a dose of 1,5 mg/kg and reduced with Diazepam 5,0 mg/kg. When testing geraniol at doses of 25, 50 and 100 mg/kg in the two apparatuses mentioned we noticed that the dose of 100 mg/kg decreased the distance traveled, the number and duration of rearing, the number and duration of head-dipping and increased immobility time in the hole-board compared to the control groups (saline and Diazepam 0,5 mg/kg). Similarly, in the open field, we observed that animals treated with geraniol (50 or 100 mg/kg) also reduced the distance traveled, the number and duration of rearing, and increased immobility time compared to the saline group and Diazepam 1,5 mg/kg . In the barbiturate-induced sleeping time test, Geraniol (100 mg/kg) did not affect sleep latency, however, increased sleep time of the animals similarly to the animals treated with diazepam 5 mg/kg. Furthermore, Geraniol (100 mg/kg) significantly increased the relative power ECoG of ultra-slow waves (0,5-1,5 Hz) and delta waves (0,5 4,0) and reduced of alfa waves (8,0-13,0 Hz). According to all gathered data, we conclude that geraniol (100 mg/kg) behaves as a hypnotic-sedative drug. / Óleos essenciais são compostos voláteis extraídos de plantas aromáticas. Entre as moléculas naturais encontradas em óleos essenciais, o Geraniol vem sendo bastante estudado. Esse já foi mostrado na literatura como um agente antimicrobiano, antioxidante, anti-inflamatório e neuroprotetor. Entretanto, ainda há escassez de estudos que abranjam a influência desse composto sobre o sistema nervoso central. Diante disso, esta pesquisa teve como objetivo caracterizar o efeito do geraniol nos padrões de ondas cerebrais, no comportamento motor e tipo ansiedade de ratos Wistar. Foram utilizados 180 ratos Wistar machos, com idade entre 3 e 4 meses, provenientes do Biotério Central e do Biotério do Laboratório de Neurofisiologia da UFS. Foram realizados testes comportamentais para avaliação de componentes motores e de ansiedade (placa perfurada e campo aberto). Também foi avaliado o tempo de sono induzido por barbitúrico. Para caracterizar o padrão de ondas cerebrais foi feito eletrocorticograma (ECoG). Foram testadas 3 doses de geraniol: 25, 50 e 100 mg/kg. Devido a divergência na literatura sobre a dose de Diazepam para controle ansiolítico nos testes da placa perfurada e campo aberto, foi realizada uma curva dose-resposta para identificação da mesma, seguida de comparação com as doses do Geraniol. Foi observado, na placa perfurada, que a dose de 2,0 mg/kg de Diazepam aumentou o tempo de imobilidade e diminuiu o número e tempo de rearing. Houve uma ampla elevação no tempo de head-dipping nos animais tratados com Diazepam 0,5 mg/kg. Quanto ao teste do campo aberto, Diazepam na dose de 5,0 mg/kg diminuiu distância percorrida, logo os animais tratados com esta dose permaneceram a maior parte do tempo imóveis. O número e tempo de rearing foram elevados nos animais tratados com Diazepam na dose de 1,5 mg/kg e reduzidos com Diazepam 5,0 mg/kg. Ao testar o Geraniol nas doses de 25, 50 e 100 mg/kg nos dois aparatos supracitados, vimos que a dose de Geraniol de 100 mg/kg diminuiu distância percorrida, número e tempo de rearing, número e tempo de head-dipping e aumentou tempo de imobilidade na placa-perfurada comparado aos grupos controles (Salina e Diazepam 0,5 mg/kg). Do mesmo modo, foi observado no campo aberto que animais tratados com Geraniol (50 e 100 mg/kg) também reduziram a distância percorrida, número e tempo de rearing e aumentaram tempo de imobilidade em relação ao grupo Salina e Diazepam 1,5 mg/kg. No teste do tempo de sono induzido por barbitúrico, Geraniol (100 mg/kg) não alterou a latência do sono, todavia elevou o tempo de sono do animal assemelhando-se aos animais tratados com Diazepam 5,0 mg/kg. Ademais, o Geraniol (100 mg/kg) aumentou significativamente a porcentagem relativa da energia de ondas ultra-lentas (0,5-1,5 Hz) e delta (0,5-4,0 Hz), e diminuiu nas ondas alfa (8,0-13,0 Hz). Diante dos dados obtidos, foi concluído que Geraniol (100 mg/kg) comporta-se como uma droga hipnótico-sedativa.

Orientador: Sandra Maria Herondina Coelho Ávila de Aguiar / Banca: Alberto Carlos Botazzo Delbem / Banca: Wilson Roberto Poi / Banca: Ruy Cesar Camargo Abdo / Banca: Salete Moura Bonifácio da Silva / Resumo: O objetivo deste estudo foi observar resultados de procedimentos odontológicos realizados em pessoas com deficiência, sob sedação consciente com Midazolam, via endovenosa, realizados no Centro de Assistência Odontológica à Pessoa com Deficiência, da Faculdade de Odontologia de Araçatuba - UNESP. Acompanhou-se 460 procedimentos, independente do gênero, idade ou deficiência dos pacientes, que não permitiram a realização de tratamento odontológico previamente. Os resultados foram classificados como sucesso (quando realizados sem problemas, ainda que necessária contenção auxiliar suave, ou houve algum problema contornável, mas os procedimentos planejados puderam ser realizados) e insucesso (quando não foi possível a realização do tratamento planejado). Registrou-se, ainda, o uso de medicamentos pelos pacientes e as prováveis causas de insucesso. A pressão arterial, freqüência cardíaca, saturação de oxigênio e temperatura corporal foram monitorados antes, durante e após o procedimento. As dosagens de Midazolam administradas foram entre 05 a 60mg, de acordo com o peso corporal do paciente. Na maioria dos casos, foi possível a realização do tratamento planejado, sem danos aos pacientes nem à equipe odontológica e os sinais vitais se mantiveram dentro de valores normais. A sedação consciente com Midazolam, via endovenosa, pode ser considerada uma alternativa eficaz para o tratamento odontológico em pessoas com deficiência não colaboradores / Abstract: The objective of this study was to observe the results of dental procedures performed in disable persons under conscious sedation with Midazolam, intravenously, assisted at the Dental Care Center for Patients with Special Needs, School of Dentistry of Araçatuba - UNESP. 460 procedures were observed, regardless of gender, age or disability of the patients, which did not allow their dental treatment realization. The results were classified as success (when carried out without problems, even it was necessary restraint gentle help, or there was some manageable problem, but the planned procedures could be performed) and failure (when it was not possible to perform the planned treatment). It was also recorded, the use of medicines by patients and the probable causes of failure results. Blood pressure, heart rate, oxygen saturation and body temperature were monitored before, during and after the procedure. The doses of Midazolam were administered between 05 to 60mg, according to the patient's body weight. In most cases it was possible to perform the planned treatment without problems to the patients or to the dental staff and their vital signs remained within normal values. The conscious sedation with Midazolam, intravenously, can be considered an effective alternative for dental treatment to disable persons not employees / Doutor

Civil law aspects of the provision of palliative care Abstract This dissertation focuses on topics related to the area of intensive medicine and palliative care. In particular, the clinical environment where legal controversies related to the confrontation of two different approaches, curative and palliative, are discussed. The dissertation follows the structure of the medical law area in common law often called "Law at the end of life". The first part of the dissertation is dedicated to an analysis of relevant concepts in a more general fashion. This includes the concept of medical futility, the legal distinction between 'withholding' and 'withdrawing' life-sustaining treatment and euthanasia. One chapter focuses on the decision-making process at the end of life, and the ways of solving conflicts amongst persons involved in the process. Another chapter is dedicated to a detailed analysis of the Czech regulation of advance directives. The second part of the dissertation focuses on specific issues related to the provision of care at the end of life. These include decisions related to cardiopulmonary resuscitation and DNR orders, the deactivation of pacemakers, and palliative sedation. The final part of the dissertation provides legal analysis of specific cases from clinical practice. The dissertation...

Background: Mechanical ventilation and sedation are common in intensive care and can be stressful for the patient as many experience physical and mental complications such as delirium. Nurses in intensive care play an important role in assessing the need for pain relief and sedation. The care environment and communication opportunities are also factors that affect patients' experiences. Aim: The aim of the study was to make patients' experiences of having been mechanically ventilated and/or sedated in an intensive care unit visible. Method: A literature study was chosen to get a picture of the current state of knowledge. Based on a thematic analysis method 15 articles were analyzed. Results: The analysis resulted in the following themes: physical and mental reactions with the subtheme fear/anxiety and pain, the importance of the environment with the subtheme security and communication and memories with the subtheme confusion and dreams. Conclusion: It is a difficult experience to be mechanically ventilated and/or sedated in an intensive care unit. Communication difficulties were a prominent experience that affected many patients. Continued research: Continued research is necessary in the subject matter of the study. There is also a need for research on the care environment and communication aids for intensive care patients. / Bakgrund: Mekanisk ventilation och sedering är vanligt förekommande inom intensivvården och kan vara påfrestande för patienten då många upplever fysiska och psykiska komplikationer som till exempel delirium. Specialistsjuksköterskor inom intensivvård har en viktig roll vid bedömning av behov av smärtlindring och sedering. Även vårdmiljö och kommunikationsmöjligheter är faktorer som påverkar patienters upplevelser. Syfte: Syftet med studien var att synliggöra patienters upplevelser av att ha varit mekaniskt ventilerade och/eller sederade på en intensivvårdsavdelning. Metod: En litteraturstudie valdes för att få en bild av det aktuella kunskapsläget. Utifrån tematisk analysmetod analyserades 15 artiklar. Resultat: Analysen resulterade i följande teman: fysiska och psykiska reaktioner med subtema rädsla/ångest och smärta, omgivningens betydelse med subtema trygghet och kommunikation samt minnen med subtema förvirring och drömmar. Slutsats: Det är en svår upplevelse att vara mekaniskt ventilerad och/eller sederad på en intensivvårdsavdelning. Kommunikationssvårigheter var en framträdande upplevelse som påverkade många patienter. Fortsatt forskning: Fortsatt forskning är nödvändig inom ämnet som studien berör. Det finns även behov av forskning kring vårdmiljön samt kommunikationshjälpmedel för intensivvårdspatienter.

Bei einer MRT in Sedierung steht der potentielle Wärmeverlust über die Körperoberfläche einem Temperaturanstieg durch die Absorption von Energie aus dem Hochfrequenzfeld der Sendespule gegenüber. Bei Schädel-MRT-Untersuchungen in bereits vorliegenden Studien (1,5T, 3T) konnte mittels Ohrtemperaturmessung vor und nach der MRT ein Temperaturanstieg von 0,5 ° C bei Säuglingen und Kleinkindern gemessen werden. In der vorliegenden Arbeit sollte untersucht werden, ob bei 3T-MRT-Untersuchungen unterschiedlicher Körperregionen und Dauer in Propofol-Sedierung bei Säuglingen und Kleinkindern eine Zu- oder Abnahme der Körpertemperatur stattfi ndet und ob eine kontinuierliche Temperaturüberwachung auf der Haut eine verlässliche Messmethode ist. In der klinischen Observationsstudie wurden 50 Kinder im Alter bis zu 6 Jahren eingeschlossen und eine 3T-MRT in Propofol-Sedierung durchgeführt (ASA 1 und 2). Erstmalig erfolgte die Temperaturüberwachung kontinuierlich axillär mit einem Fiber TEMPTM Reusable Fiber-optic Surface Temperature Sensor (Invivo, Orlando/Florida, USA). Zur Kontrolle wurde die Ohrtemperatur vor und nach der MRT mit einem Infrarotthermometer First Temp Genius (Covidien Deutschland GmbH) gemessen und vegetative Reaktionen dokumentiert. Es zeigte sich ein mit der Literatur vergleichbarer signi fikanter mittlerer Temperaturanstieg auf der Haut von 36,4 ± 0,5 °C auf 36,9 ± 0,5 ° C auch bei unterschiedlichen Untersuchungszeiten und -regionen. Die nachgewiesene Erwärmung ist bei gesunden Kindern nur von geringer klinischer Relevanz. Es sind bei einer 3T-MRT-Untersuchung weder eine verstärkte Wärmezufuhr noch eine Kühlung notwendig, um Säuglinge und Kleinkinder normotherm zu halten. Ist bei speziellen Indikationen eine kontinuierliche Temperaturüberwachung notwendig, liefert ein faseroptischer Temperatursensor korrekte Daten. / In case of MRI in infants and children during propofol sedation the potential loss of body temperature confronts the temperature increase due to the absorption of energy from the high-frequency field of the transmitter coil. Therefore the physician must be aware of both effects when caring for sedated children. Objective of the present study is the effect of 3T-MRI of different body regions and scan duration on body temperature measured continuously in propofol sedated infants and children, which was not performed previously. 50 children in the age up to 6 years have been included in the observational study carried out between October 2008 and March 2009 at the Department of Pediatric Radiology, University of Leipzig. They underwent an elective 3T-MRI while sedated with propofol. The temperature monitoring has been carried out continuously axillary with a new fiber-optic sensor. For control, the tympanic temperature has been measured prior and after the MRI-examination with an infrared thermometer. A significant (p<0,05) medial temperature increase from 36,4 ± 0,5 °C to 36,9 ± 0,5 °C was evident measured axillarly with the fiber-optic sensor. Heart rate and oxygen saturation were stable throughout the MRI scan. In healthy children, the measured increase of temperature during 3T-MRI is only of minor clinical relevance. If a continuous temperature monitoring is necessary in cases with special indications e.g. critical ill children, a fiber-optical temperature sensor generates reliable data.

Bakgrund: Att vårda intensivvårdspatienter som genomgår respiratorbehandling utan eller med lättare sedering börjar alltmer bli vanligare på intensivvårdsavdelningarna. Anledningen till varför denna behandlingstyp blir vanligare är för att minska på komplikationer som sederingen kan medföra. Patienternas upplevelser är av stor vikt då deras upplevelser tidigare har redovisats enbart ett fåtal gånger och kräver ständig uppdatering. Ramverket Fundamentals of Care och integrerad vård har varit utgångspunkten i litteraturöversikten.  Syfte: Att belysa intensivvårdspatienters upplevelser under respiratorbehandling utan eller med lättare sedering. Metod: En beskrivande litteraturöversikt med en systematisk ansats har utförts. Elva artiklar, varav sju var kvalitativa och fyra av mixad metod, av hög och medelhög kvalitet som svarade på syftet har utgjort analysenheterna. Analysen av artiklarna är baserad på kvalitativ innehållsanalys.  Huvudresultat: Fyra huvudfynd har tagits fram; smärta och obehag, vikten av delaktighet och vårdpersonalens närvaro, kommunikationshinder och stöd samt en främmande situation vilka belyser några av de upplevelser som intensivvårdspatienterna hade från intensivvårdstiden.  Slutsats: Mer tekniska och avancerade kommunikationshjälpmedel behövs för en förbättrad kommunikation och det är viktigt att göra patienten delaktig i sin vård. Smärta och obehag behöver generellt lindras mer och närstående är viktiga för intensivvårdspatienten. En bättre fysisk, psykosocial och relationell hälsa kan gynnas av mer positiva upplevelser från intensivvårdstiden. Fortsatt forskning inom omvårdnad anses vara viktigt och bör utvecklas om intensivvårdspatienter ska kunna få bättre upplevelser av att genomgå respiratorbehandling och vara utan eller med lättare sedering. / Background: Caring for intensive care patients undergoing mechanical ventilation without or with light sedation is becoming more common in the intensive care units. The reason is to reduce the complications that sedation can cause. Patients' experiences are of great importance and have previously been reported a few times and require constant update. The literature review is based on the framework Fundamentals of Care and integration of care. Purpose: To elucidate intensive care patients' experiences during mechanical ventilation without or with light sedation. Method: A descriptive literature review with a systematic approach has been conducted. Eleven articles constituted the analytical units. The analysis of the articles is based on qualitative content analysis. Main results: Four main findings have emerged; pain and discomfort, the importance of participation and the presence of care staff, communication barriers and support as well as an unfamiliar situation that highlights some of the experiences that the intensive care patients had from the intensive care period. Conclusion: More technical and advanced communication tools are needed for improved communication and it is important to involve the patient in their care. More relief is generally needed for pain and discomfort and relatives are important for the intensive care patient. Better physical, psychosocial and relational health can benefit from more positive experiences from the intensive care period. Continued research in nursing care is considered important and should be developed if intensive care patients should be able to have better experiences of undergoing respiratory therapy and be without or with light sedation.

Den palliativa vårdens ambition är att lindra symtom vid obotlig sjukdom och att främja livskvalitet för patienter och deras närstående vid fysiska, psykologiska, sociala eller existentiella behov. Inom den specialiserade palliativa vården finns patienter med komplexa symtombilder som i livets slutskede inte kan symtomlindras annat än med hjälp av palliativ sedering som behandlingsform. Genom att kontrollerat sänka patientens medvetande minskar lidandet och ger patienten möjlighet till en fridfull och värdig död. Sjuksköterskan ansvarar för det praktiska utförandet av sederingen och omvårdnaden av patienten tills döden inträder. Syftet med denna studie var att beskriva sjuksköterskors reflektioner och resonemang kring palliativ sedering i livets slutskede. Metoden för arbetet var semistrukturerade intervjuer i fokusgrupper. Inklusionskriterierna var legitimerade sjuksköterskor, yrkesverksamma inom den palliativa slutenvården med personlig erfarenhet av att ha varit delaktig i beslut, ha iordningsställt och administrerat behandling där syftet var palliativ sedering. I föreliggande intervjustudie avsågs en kontinuerlig sedering. Dataanalysen genomfördes med hjälp av en kvalitativ manifest innehållsanalys. Resultatet består av de fem kategorierna den beslutsfattande processen, läkemedelshantering, närståendeperspektiv, sjuksköterskans roll och utbildning. Huvudfynden var osäkerhet och kunskapsbrist gällande skillnaden mellan behandlingens avsikt och biverkan av en symtomlindrande behandling. Sjuksköterskan upplevde inte beslutet om palliativ sedering som känslomässigt belastande när det fanns tydligt stöd i teamets dokumentation och i verksamhetens riktlinjer och struktur. Slutsatsen är att det finns ett behov av utbildning bland sjuksköterskor gällande palliativ sedering, både internt på arbetsplatsen och externt i större forum. Ett sätt att öka medvetenheten och kunskapen kring palliativ sedering kan vara att arrangera ett event om palliativ sedering med workshops i södra Sverige. Ett annat sätt kan vara möjlighet till reflektion i arbetsgruppen där diskussionen med kollegor kan bidra med en ökad trygghet hos sjuksköterskan vid ansvar för palliativ sedering. Att få reflektera är betydelsefullt och underlättar möjligheten att våga fråga och erkänna osäkerhet inför palliativ sedering. / The ambition of palliative care is to relieve symptoms of uncurable diseases and to support the quality of life for both the patients and their families regarding physical, psychological, social and existential needs. Towards end of life patients with complex symptoms who can’t get enough relief of refractory symptoms but through sedation, can get treatment performed by the specialized palliative care. A controlled decrease of consciousness will eliminate the suffering and allow the patient to die peacefully and with dignity. The nurse has the responsibility of the practical assignments regarding the palliative sedation and the care until death occurs.  The aim of this study was to describe the reflections and reasoning of the nurses concerning palliative sedation in the end of life. The method in the study was semi-structured interviews in focusgroups. The inclusion criteria were registered nurses working in palliative ward care with personal experience of being involved in decision-making, preparing and administration of the treatment with the purpose palliative sedation. The present study is concerning continuous sedation. The analysis was conducted using a qualitative manifest content analysis. The result consists of the five main categories the decision-making process, handling medications, the perspective of family and loved ones, the role of the nursing profession och education. The main findings were the nurses’ insecurity and lack of knowledge concerning the difference between the purpose of the treatment and the side-effects of a symptomreducing treatment. Clear guidelines, accurate documentation and explicit support from the team reduced the mental stress of palliative sedation among nurses at a great extent. In conclusion, nurses have a need of education concerning palliative sedation, both internal in the workplace and external in a wider forum. One way to raise awareness and increase knowledge could be to arrange an event about palliative sedation with workshops in the south of Sweden. Another approach is getting the possibility of reflection in the team. The discussions with colleagues could increase security in nursing when responsible of palliative sedation. Reflecting is significant and facilitates the possibility to dare to pose questions and admit insecurity about palliative sedation.

No description available.

The paper explores historical positions on suicide and philosophical, theological, and moral positions on physician-assisted suicide and euthanasia. In 1900, most people died from infectious diseases, which have relatively short periods of morbid decline. With advances in the biomedical sciences, people are living longer, and most people die from chronic diseases, which are usually accompanied by prolonged periods of morbid decline. In addition to living longer, people today are generally more individualist and seek methods to control many aspects of life. While assisted death is rarely used, it represents a means to control end-of-life suffering. The paper demonstrates that there is substantial opposition to assisted death among philosophers, theologians and bioethicists. The paper also argues that improved education about end-of-life palliative alternatives would alleviate fears about end-of-life suffering. The thesis is that the use of palliative alternatives is morally and ethically superior to physician-assisted suicide or euthanasia.

Bakgrund: Palliativ vård syftar till att förbättra livskvalitet hos patienter med livshotande sjukdom samt deras närstående. Begreppet total pain används i palliativ vård för att tydliggöra den multidimensionella funktionen av lidande och belyser att det inte bara rör sig om fysiskt lidande, utan även psykiskt, existentiellt och socialt lidande. Palliativ sedering är en medicinsk intervention som genom att sänka vakenhetsgraden hos patienten syftar till att lindra lidande där inget annat behandlingsalternativ givit adekvat lindring vid exempelvis smärta och ångest. Etiska konflikter kan uppstå kring palliativ sedering av flera anledningar, bland annat patientens förlust av autonomi och icke-konsekvent terminologi rörande begreppet palliativ sedering. Sjuksköterskans roll under palliativ sedering innebär bland annat stöd till patient och närstående, administrering av läkemedel, övervakning av patienten och utvärdering av behandlingen.  Syfte: Syftet var att beskriva sjuksköterskors erfarenheter i samband med palliativ sedering.  Metod: Litteraturöversikt byggd på systematisk grund. Endast sjuksköterskors erfarenheter inkluderas även om originalstudien har granskat andra professioner. Analys av data sker genom användning av Graneheim och Lundmans kvalitativa innehållsanalys. Resultat: Studier från Europa, Sydamerika och Asien inkluderades. Resultatet redovisas i två huvudkategorier med fem underkategorier. Sjuksköterskor beskrev att palliativ sedering initieras för att lindra lidande. Däremot uppstod etisk tress kring palliativ sedering, exempelvis när palliativ sedering jämfördes med eutanasi. Vidare hade sjuksköterskan en nyckelroll i att bevara patientens önskemål och autonomi. Sjuksköterskor erfor att de har ett stort ansvar vad gäller administrering och övervakning under sederingen. Etisk stress uppstod när anhöriga trodde att sjuksköterskan kunde påskynda döden genom palliativ sedering. Närståendestöd och informationsdelning var två väsentliga komponenter under tiden patienten är sederad, enligt flertalet sjuksköterskors erfarenheter.  Slutsats: Sjuksköterskor erfar palliativ sedering som ett behandlingsalternativ med syfte att lindra lidande, men inte utan etiska utmaningar. / Background: Palliative care aims to improve the quality of life of patients with lifethreatening illness and their relatives. The concept of total pain is used in palliative care to clarify the multidimensional function of suffering and highlights that it is not only physical suffering, but also psychological, existential, and social suffering. Palliative sedation is a medical intervention that, by lowering the patient's level of alertness, aims to relieve suffering where no other treatment option has provided adequate relief from, for example, pain and anxiety. Ethical conflicts can arise around palliative sedation for several reasons, including the patient's loss of autonomy and inconsistent terminology regarding palliative sedation. The role of the nurse during palliative sedation includes support to the patient and relatives, administration of medication, monitoring of the patient and evaluation of treatment.  Aim: The aim of this literature review was to explore nurses’ experiences of palliative sedation.  Method: Literature review based on a systematic basis. Only nurses' experiences were included, although the original study has examined other professions. Analysis of the data is done through the use of Graneheim and Lundman's qualitative content analysis.  Results: Studies from Europe, South America and Asia were included. The results are presented in two main categories with five subcategories. Nurses described that palliative sedation is initiated to relieve suffering, but that there was ethical stress about palliative sedation, such as when palliative sedation was compared to euthanasia. Furthermore, the nurse had a key role in preserving the patient's wishes and autonomy. Nurses experienced that they have a great responsibility when it comes to administration and monitoring during sedation. Ethical stress arose when relatives believed that the nurse could hasten death through palliative sedation. Family support and information sharing were two essential components during the time the patient is sedated, according to most nurses' experiences.  Conclusion: Nurses experience palliative sedation as a treatment option with the aim of relieving suffering, but not without ethical challenges.