Backround: Refractory dyspnea (DR) refers to the subjective experience of respiratory discomfort that persists despite the optimal treatment for the underlying pathophysiology, conditioning an important functional limitation with the consequent affectation in the quality of life; It is part of the effects of terminal chronic diseases (PCT), it is associated as a marker of poor prognosis and it is often considered the most distressing symptom experienced by cancer patients, in whom in many cases palliative sedation is required as final treatment. of life.Methodology: Given the prevalence of DR in cancer patients with terminal cancer pathologies, a review of the literature is carried out.Results: The cause of DR was mostly due to lung metastasis secondary to breast cancer and sigmoid colon adenocarcinoma.The sedative drugs used were Midazolam in doses from 1 to 2 mg IV every 4 to 6 hours, the maximum dose being 10 mg/hour; In addition to this, opioids were used to optimize the effects of the sedative and symptomatic pain management.the most widely used opioid was morphine at a dose of 1mg/h (rescue 3mg/pain or marked dyspnea), followed by hydromorphone 0.5-0.7 mg/4 hours (rescue 1.2 mg; maximum 4/24 h).fentanyl at 200 mcg/kg/h and oxycodone 3 mg/h, which generated symptomatic control with decreased dyspnea.The survival of the patients once the sedation was started was generally short, the patients died the same day or the day after the start of the sedation[1],[2], [3].Conclusions: The use of benzodiazepines as a pillar in palliative sedation, accompanied by low-dose systemic opioids are useful in the management of DR in terminal cancer patients with SP.SP does not prolong or reduce the patient's lifetime.Even when DR is low, it must be considered and managed, given the effects on the patient and the family, so treating it improves the quality of life of the patient and the family at the end of their life.