Risikoerfassung und optimierende Therapie bei muskulären und neuromuskulären Störungen

  • J. Plötz
Conference paper

Zusammenfassung

Neuromuskuläre Synapse und Muskelfaser stehen während der Anästhesie unter dem Einfluß von Relaxanzien [4, 65], Narkotika [58, 102,110, 111] und Lokalanästhetika [27, 65], die allesamt Muskelsehwäche bewirken können. Bereits beim Muskelgesunden ergibt sich durch verlängerte Wirkung einzelner Anästhetika eine potentielle Risikobelastung für Atemakt und Gasaustausch, die sich bei sachkundiger Anästhesieführung jedoch nicht zu bedrohlichen Folgen ausweitet. Patienten mit neuromuskulären Störungen sind hingegen in höherem Maße durch Komplikationen gefährdet - nicht nur seitens der Atemmuskulatur, sondern u. a. auch als Folge der Mitbeteiligung von Myokard und weiteren Organen [33]. Es stellt sich daher die Frage, ob und inwieweit das Risiko rechtzeitig erfaßt und begrenzt werden kann. Die Thematik hat ihr eigenes Gesicht je nach Störung, wobei eine ausgesprochene Vielfalt besteht. Sie soll behandelt werden in bewußter Beschränkung auf wenige Beispiele und in der Absicht, neben speziellen auch allgemeine Gesichtspunkte anzusprechen.

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  • J. Plötz

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