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Postoperative Maßnahmen

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AE-Manual der Endoprothetik

Zusammenfassung

Eine exakte Dokumentation aller wichtigen, postoperativen Befunde ist absolut zu fordern. Insbesondere lassen sich daraus meist rechtzeitig gefährliche Entwicklungen erkennen und entsprechend früh Gegenmaßnahmen einleiten.

Wichtig ist, dass die Abläufe der postoperativen Kontrollen einem klinikintern festgelegten Plan entsprechen. Dazu eignen sich Dokumentationsformulare, die den Patienten in den folgenden, wenigstens 24 Stunden begleiten und alle erforderlichen Kontrollen in Form einer Checkliste erfassen, bis am 1. postoperativen Tag das übliche Pflegeprotokoll sowie die Visiten und die Verlaufsdokumentationen greifen.

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Literatur

  • Abouleish E, Rawal N, Shaw J, Lorenz T, Rashad MN (1991) Intrathecal morphine 0.2 mg versus epidural bupivacaine 0.125 % or their combination: effects on parturients. Anesthesiology 74:711–716

    Article  PubMed  CAS  Google Scholar 

  • Alexander R, El-Moalem HE, Gan TJ (2002) Comparison of the morphine-sparing effects of diclofenac sodium and ketorolac tromethamine after major orthopedic surgery. J Clin Anesth 14:187–192

    Article  PubMed  CAS  Google Scholar 

  • An HS, Mikhail WE, Jackson WT, Tolin B, Dodd GA (1991) Effects of hypotensive anesthesia, nonsteroidal antiinflammatory drugs, and polymethylmethacrylate on bleeding in total hip arthroplasty patients. J Arthroplasty 6:245–250

    Article  PubMed  CAS  Google Scholar 

  • Anderson AD, McNaught CE, MacFie J, Tring I, Barker P, Mitchell CJ (2003) Randomized clinical trial of multimodal optimization and standard perioperative surgical care. Br J Surg 90:1497–1504

    Article  PubMed  CAS  Google Scholar 

  • Auroy Y, Narchi P, Messiah A, Litt L, Rouvier B, Samii K (1997) Serious complications related to regional anesthesia: results of a prospective survey in France. Anesthesiology 87:479–486

    Article  PubMed  CAS  Google Scholar 

  • Auroy Y, Benhamou D, Bargues L, Ecoffey C, Falissard B, Mercier FJ, Bouaziz H, Samii K (2002) Major complications of regional anesthesia in France: the SOS regional anesthesia hotline service. Anesthesiology 97:1274–1280

    Article  PubMed  Google Scholar 

  • Bailey PL, Lu JK, Pace NL, Orr JA, White JL, Hamber EA, Slawson MH, Crouch DJ, Rollins DE (2000) Effects of intrathecal morphine on the ventilatory response to hypoxia. N Engl J Med 343:1228–1234

    Article  PubMed  CAS  Google Scholar 

  • Ballantyne JC, Carr DB, deFerranti S, Suarez T, Lau J, Chalmers TC, Angelillo IF, Mosteller F (1998) The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg 86:598–612

    PubMed  CAS  Google Scholar 

  • Bardiau FM, Taviaux NF, Albert A, Boogaerts JG, Stadler M (2003) An intervention study to enhance postoperative pain management. Anesth Analg 96:179–185

    PubMed  Google Scholar 

  • Basbaum AI (1999) Spinal mechanisms of acute and persistent pain. Reg Anesth Pain Med 24:59–67

    PubMed  CAS  Google Scholar 

  • Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X (2004) Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or psoas compartment block. a prospective, randomized, double-blind study. Reg Anesth Pain Med 29:102–109

    PubMed  CAS  Google Scholar 

  • Bourke M, Hayes A, Doyle M, McCarroll M (2000) A comparison of regularly administered sustained release oral morphine with intramuscular morphine for control of postoperative pain. Anesth Analg 90:427–430

    PubMed  CAS  Google Scholar 

  • Bugter ML, Dirksen R, Jhamandas K, Slappendel R, Weber EW, Milne B (2003) Prior ibuprofen exposure does not augment opioid drug potency or modify opioid requirements for pain inhibition in total hip surgery. Can J Anaesth 50:445–449

    Article  PubMed  Google Scholar 

  • Camu F, Beecher T, Recker DP, Verburg KM (2002) Valdecoxib, a COX-2-specific inhibitor, is an efficacious, opioid-sparing analgesic in patients undergoing hip arthroplasty. Am J Ther 9:43–51

    Article  PubMed  Google Scholar 

  • Carr EC, Nicky TV, Wilson-Barnet J (2005) Patient experiences of anxiety, depression and acute pain after surgery: a longitudinal perspective. Int J Nurs Stud 42:521–530

    Article  PubMed  Google Scholar 

  • Chumbley GM, Ward L, Hall GM, Salmon P (2004) Pre-operative information and patient-controlled analgesia: much ado about nothing. Anaesthesia 59:354–358

    Article  PubMed  CAS  Google Scholar 

  • Dahl V, Raeder JC, Drosdal S, Wathne O, Brynildsrud J (1995) Prophylactic oral ibuprofen or ibuprofen-codeine versus placebo for postoperative pain after primary hip arthroplasty. Acta Anaesthesiol Scand 39:323–326

    Article  PubMed  CAS  Google Scholar 

  • Daltroy LH, Morlino CI, Eaton HM, Poss R, Liang MH (1998) Preoperative education for total hip and knee replacement patients. Arthritis Care Res 11:469–478

    Article  PubMed  CAS  Google Scholar 

  • Devine EC (1992) Effects of psychoeducational care for adult surgical patients: a meta-analysis of 191 studies. Patient Educ Couns 19:129–142

    Article  PubMed  CAS  Google Scholar 

  • Dorr LD, Maheshwari AV, Long WT, Wan Z, Sirianni LE (2007) Early pain relief and function after posterior minimally invasive and conventional total hip arthroplasty. A prospective, randomized, blinded study. J Bone Joint Surg Am 89:1153–1160

    Article  PubMed  Google Scholar 

  • Drabiniok T, Sonnekalb U, Heisel J (2001) Stationäre Anschlussheilbehandlung nach alloarthroplastischem Hüftgelenksersatz bei älteren Menschen. Orth Prax 38:794

    Google Scholar 

  • Evans E, Turley N, Robinson N, Clancy M (2005) Randomised controlled trial of patient controlled analgesia compared with nurse delivered analgesia in an emergency department. Emerg Med J 22:25–29

    Article  PubMed  CAS  Google Scholar 

  • Fass V, Müller W (1994) Postoperative Rehabilitation und Physiotherapie des älteren Patienten nach totalendoprothetischer Versorgung. Orth Prax 30:211

    Google Scholar 

  • Fischer HB, Simanski CJ (2005) A procedure-specific systematic review and consensus recommendations for analgesia after total hip replacement. Anaesthesia 60:1189–1202

    Article  PubMed  CAS  Google Scholar 

  • Fletcher D, Zetlaoui P, Monin S, Bombart M, Samii K (1995) Influence of timing on the analgesic effect of intravenous ketorolac after orthopedic surgery. Pain 61:291–297

    Article  PubMed  CAS  Google Scholar 

  • Fournier R, Van Gessel E, Gaggero G, Boccovi S, Forster A, Gamulin Z (1998) Postoperative analgesia with „3-in-1“ femoral nerve block after prosthetic hip surgery. Can J Anaesth 45:34–38

    Article  PubMed  CAS  Google Scholar 

  • Fransen M, Neal B (2004) Non-steroidal anti-inflammatory drugs for preventing heterotopic bone formation after hip arthroplasty. Cochrane Database Syst Rev 2004:CD001160

    Google Scholar 

  • Gallagher EJ, Liebman M, Bijur PE (2001) Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med 38:633–638

    Article  PubMed  CAS  Google Scholar 

  • Goebel S, Wollmerstedt N, Lobmuller A, Walther M, Kirschner S, Eulert J (2009) Implementation of standardized postoperative pain therapy for orthopaedic patients. Comparison between unsystematic and standardized pain therapy. Orthopäde 38:444–454

    Article  PubMed  CAS  Google Scholar 

  • Griffin MJ, Brennan L, McShane AJ (1998) Preoperative education and outcome of patient controlled analgesia. Can J Anaesth 45:943–948

    Article  PubMed  CAS  Google Scholar 

  • Guruge S, Sidani S (2002) Effects of demographic characteristics on preoperative teaching outcomes: a meta-analysis. Can J Nurs Res 34:25–33

    PubMed  Google Scholar 

  • Heisel J (2001) Rehabilitation und Belastbarkeit von Hüftendoprothesenpatienten mit Gelenkgleitpaarung Keramik/Keramik: Was gilt zu beachten? In: Toni A, Willmann G (Hrsg) Bioceramics in joint arthroplasty. Thieme, Stuttgart, S 45

    Google Scholar 

  • Heisel J (2005) Physikalische Medizin. Thieme, Stuttgart

    Google Scholar 

  • Heisel J (2006) Dynamische Hüftorthese zur Behandlung der postoperativen Instabilität nach Hüft-TEP. Orth Prax 42:493

    Google Scholar 

  • Heisel J (2009) Standardisierte Rehabilitation nach Hüft-TEP. Orth Prax 45:351

    Google Scholar 

  • Heisel J, Jerosch J (1996) Rehabilitationsmaßnahmen nach künstlichem Hüftgelenkersatz – eine notwendige Maßnahme? Orth Prax 32:683

    Google Scholar 

  • Heisel J, Jerosch J (2007) Rehabilitation nach Hüft- und Knieendoprothese. Deutscher Ärzte-Verlag, Köln

    Google Scholar 

  • Heisel J, Drabiniok T, Bork H (1998) Postoperative Belastungsstrategie nach alloarthroplastischem Hüftgelenksersatz. Med Orth Techn 118:170

    Google Scholar 

  • Heye ML, Foster L, Bartlett MK, Adkins S (2002) A preoperative intervention for pain reduction, improved mobility, and self-efficacy. Appl Nurs Res 15:174–183

    Article  PubMed  Google Scholar 

  • Jerosch J, Heisel J (1996) Endoprothesenschule. Rehabilitations- und Betreuungskonzepte für die ärztliche Praxis. Deutscher Ärzte-Verlag, Köln

    Google Scholar 

  • Jerosch J, Heisel J (2001) Künstlicher Gelenkersatz Hüfte – Knie – Schulter. Pflaum, München

    Google Scholar 

  • Johansson K, Nuutila L, Virtanen H, Katajisto J, Salantera S (2005) Preoperative education for orthopaedic patients: systematic review. J Adv Nurs 50:212–223

    Article  PubMed  Google Scholar 

  • Kehlet H (1997) Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 78:606–617

    Article  PubMed  CAS  Google Scholar 

  • Knoerl DV, Faut-Callahan M, Paice J, Shott S (1999) Preoperative PCA teaching program to manage postoperative pain. Medsurg Nurs 8:25–33, 36

    PubMed  CAS  Google Scholar 

  • Laitinen J, Nuutinen L (1992) Intravenous diclofenac coupled with PCA fentanyl for pain relief after total hip replacement. Anesthesiology 76:194–198

    Article  PubMed  CAS  Google Scholar 

  • Lam KK, Chan MT, Chen PP, Ngan Kee WD (2001) Structured preoperative patient education for patient-controlled analgesia. J Clin Anesth 13:465–469

    Article  PubMed  CAS  Google Scholar 

  • Lee A, Done ML (2004) Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev 2004:CD003281

    Google Scholar 

  • Lee H, Ernst E (2005) Acupuncture analgesia during surgery: a systematic review. Pain 114:511–517

    Article  PubMed  Google Scholar 

  • Lin LY, Wang RH (2005) Abdominal surgery, pain and anxiety: preoperative nursing intervention. J Adv Nurs 51:252–260

    Article  PubMed  Google Scholar 

  • Maurer K, Bonvini JM, Ekatodramis G, Serena S, Borgeat A (2003) Continuous spinal anesthesia/analgesia vs. single-shot spinal anesthesia with patient-controlled analgesia for elective hip arthroplasty. Acta Anaesthesiol Scand 47:878–883

    Article  PubMed  CAS  Google Scholar 

  • Middeldorf S, Casser H-R (2000) Verlaufs- und Ergebnisevaluation stationärer Rehabilitationsmaßnahmen nach alloarthroplastischem Hüft- und Kniegelenkersatz mit dem Staffelstein-Score. Orth Prax 36:230

    Google Scholar 

  • Moiniche S, Hjortso NC, Hansen BL, Dahl JB, Rosenberg J, Gebuhr P, Kehlet H (1994) The effect of balanced analgesia on early convalescence after major orthopaedic surgery. Acta Anaesthesiol Scand 38:328–335

    Article  PubMed  CAS  Google Scholar 

  • Mollmann M, Cord S, Holst D, Auf der Landwehr U (1999) Continuous spinal anaesthesia or continuous epidural anaesthesia for post-operative pain control after hip replacement? Eur J Anaesthesiol 16:454–461

    PubMed  CAS  Google Scholar 

  • Moore KN, Estey A (1999) The early post-operative concerns of men after radical prostatectomy. J Adv Nurs 29:1121–1129

    Article  PubMed  CAS  Google Scholar 

  • Neugebauer E, Sauerland S, Keck V, Simanski C, Witte J (2003) Surgical pain management. A Germany-wide survey including the effect of clinical guidelines. Chirurg 74:235–238

    Article  PubMed  CAS  Google Scholar 

  • O’Sullivan G, Bullingham RE, McQuay HJ, Poppleton P, Rolfe M, Weir L, Moore RA (1983) A comparison of intramuscular and sublingual buprenorphine, intramuscular morphine and placebo as premedication. Anaesthesia 38:977–984

    Article  PubMed  Google Scholar 

  • Ogonda L, Wilson R, Archbold P, Lawlor M, Humphreys P, O’Brien S, Beverland D (2005) A minimal-incision technique in total hip arthroplasty does not improve early postoperative outcomes. A prospective, randomized, controlled trial. J Bone Joint Surg Am 87:701–710

    Article  PubMed  Google Scholar 

  • Ozalp G, Sarioglu R, Tuncel G, Aslan K, Kadiogullari N (2003) Preoperative emotional states in patients with breast cancer and postoperative pain. Acta Anaesthesiol Scand 47:26–29

    Article  PubMed  CAS  Google Scholar 

  • Power I, Cumming AD, Pugh GC (1992) Effect of diclofenac on renal function and prostacyclin generation after surgery. Br J Anaesth 69:451–456

    Article  PubMed  CAS  Google Scholar 

  • Protz W, Gerdes N, Maier-Riehle B, Jäckel WH (1998) Therapieziele in der medizinischen Rehabilitation. Rehabilitation 37 (Suppl 1):24

    Google Scholar 

  • Raffaeli W, Marconi G, Fanelli G, Taddei S, Borghi GB, Casati A (2006) Opioid-related side-effects after intrathecal morphine: a prospective, randomized, double-blind dose-response study. Eur J Anaesthesiol 23:605–610

    Article  PubMed  CAS  Google Scholar 

  • Raja SN, Dougherty PM (2000) Reversing tissue injury-induced plastic changes in the spinal cord: the search for the magic bullet. Reg Anesth Pain Med 25:441–444

    PubMed  CAS  Google Scholar 

  • Reiter A, Zulus E, Hartmann T, Hoerauf K (2003) Preoperative oral administration of fast-release morphine sulfate reduces postoperative piritramide consumption. Wien Klin Wochenschr 115:417–420

    Article  PubMed  CAS  Google Scholar 

  • Romano CL, Duci D, Romano D, Mazza M, Meani E (2004) Celecoxib versus indomethacin in the prevention of heterotopic ossification after total hip arthroplasty. J Arthroplasty 19:14–18

    Article  PubMed  Google Scholar 

  • Salo D, Eget D, Lavery RF, Garner L, Bernstein S, Tandon K (2003) Can patients accurately read a visual analog pain scale? Am J Emerg Med 21:515–519

    Article  PubMed  Google Scholar 

  • Segstro R, Morley-Forster PK, Lu G (1991) Indomethacin as a postoperative analgesic for total hip arthroplasty. Can J Anaesth 38:578–581

    Article  PubMed  CAS  Google Scholar 

  • Slappendel R, Weber EW, Benraad B, Dirksen R, Bugter ML (2002) Does ibuprofen increase perioperative blood loss during hip arthroplasty? Eur J Anaesthesiol 19:829–831

    PubMed  CAS  Google Scholar 

  • Souron V, Delaunay L, Schifrine P (2003) Intrathecal morphine provides better postoperative analgesia than psoas compartment block after primary hip arthroplasty. Can J Anaesth 50:574–579

    Article  PubMed  Google Scholar 

  • Stadler M, Schlander M, Braeckman M, Nguyen T, Boogaerts JG (2004) A cost-utility and cost-effectiveness analysis of an acute pain service. J Clin Anesth 16:159–167

    Article  PubMed  Google Scholar 

  • Stevens RD, Van Gessel E, Flory N, Fournier R, Gamulin Z (2000) Lumbar plexus block reduces pain and blood loss associated with total hip arthroplasty. Anesthesiology 93:115–121

    Article  PubMed  CAS  Google Scholar 

  • Stubhaug A, Grimstad J, Breivik H (1995) Lack of analgesic effect of 50 and 100 mg oral tramadol after orthopaedic surgery: a randomized, double-blind, placebo and standard active drug comparison. Pain 62:111–118

    Article  PubMed  CAS  Google Scholar 

  • Turner G, Blake D, Buckland M et al. (1996) Continuous extradural infusion of ropivacaine for prevention of postoperative pain after major orthopaedic surgery. Br J Anaesth 76:606–610

    Article  PubMed  CAS  Google Scholar 

  • Ulsenheimer K, Erlinger R (2001) Liability of the consulting physician. Z Arztl Fortbild Qualitatssich 95:609–615

    PubMed  CAS  Google Scholar 

  • Usichenko TI, Dinse M, Hermsen M, Witstruck T, Pavlovic D, Lehmann C (2005) Auricular acupuncture for pain relief after total hip arthroplasty – a randomized controlled study. Pain 114:320–327

    Article  PubMed  CAS  Google Scholar 

  • Usichenko TI, Dinse M, Lysenyuk VP, Wendt M, Pavlovic D, Lehmann C (2006) Auricular acupuncture reduces intraoperative fentanyl requirement during hip arthroplasty – a randomized double-blinded study. Acupunct Electrother Res 31:213–221

    PubMed  Google Scholar 

  • Walder B, Schafer M, Henzi I, Tramer MR (2001) Efficacy and safety of patient-controlled opioid analgesia for acute postoperative pain. A quantitative systematic review. Acta Anaesthesiol Scand 45:795–804

    Article  PubMed  CAS  Google Scholar 

  • Werner MU, Soholm L, Rotboll-Nielsen P, Kehlet H (2002) Does an acute pain service improve postoperative outcome? Anesth Analg 95:1361–1372

    Article  PubMed  Google Scholar 

  • Wohlrab D, Hagel A, Hein W (2004) Advantages of minimal invasive total hip replacement in the early phase of rehabilitation. Z Orthop Ihre Grenzgeb 142:685–690

    Article  PubMed  CAS  Google Scholar 

  • Wulf H, Biscoping J, Beland B, Bachmann-Mennenga B, Motsch J (1999) Ropivacaine epidural anesthesia and analgesia versus general anesthesia and intravenous patient-controlled analgesia with morphine in the perioperative management of hip replacement. Ropivacaine Hip Replacement Multicenter Study Group. Anesth Analg 89:111–116

    PubMed  CAS  Google Scholar 

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Kirschner, P., Goebel, S., Rudert, M., Heisel, J. (2012). Postoperative Maßnahmen. In: Claes, L., Kirschner, P., Perka, C., Rudert, M. (eds) AE-Manual der Endoprothetik. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-14646-6_9

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