Skip to main content

Analgosedierung mit Opioiden

  • Conference paper
ZAK München 1987

Zusammenfassung

Während die sog. kleinen (antipyretisch-antiphlogistischen) Analgetika wie Acetylsalicylsäure, Metamizol oder Paracetamol im Rahmen der operativen Intensivmedizin relativ unbedeutend sind, weil sie (für diese Art von Schmerzen) als zu wenig potent und hinsichtlich der Nebenwirkungen (Gerinnungshemmung, Schädigung der Magen-Darm-Schleimhaut) als zu gefährlich gelten, spielen Morphinderivate bei der medikamentösen Ruhigstellung traditionell eine entscheidende Rolle.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Aitkenhead AR, Vater M, Achola K, Cooper CMS, Smith G (1984) Pharmacokinetics of single-dose i. v. morphine in normal volunteers and patients with en-stage renal failure. Br J Anaesth 56: 813–819

    Article  PubMed  CAS  Google Scholar 

  2. Ausems ME, Stanski DR, Hug CC (1985) An evaluation of the accuracy of pharmacokinetic data for the computer assisted infusion of alfentanil. Br J Anaesth 57: 1217–1225

    Article  PubMed  CAS  Google Scholar 

  3. Ball M, McQuay HJ, Moore RA, Allen MC, Fisher A, Sear J (1985) Renal failure and the use of morphine in intensive care. Lancet 1: 784–786

    Article  PubMed  CAS  Google Scholar 

  4. Behne M, Asskali F, Steuer A, Förster H (1987) Midazolam-Dauerinfusion zur Sedierung von Beatmungspatienten. Anaesthesist 36: 228–232

    PubMed  CAS  Google Scholar 

  5. Bingham RM, Hinds CJ (1987) Influence of bolus doses of phenoperidine on intracranial pressure and systemic arterial pressure in traumatic coma. Br J Anaesth 59: 592–595

    Article  PubMed  CAS  Google Scholar 

  6. Bird TM, Edbrooke DL, Newby DM, Hebron BS (1984) Intravenous sedation for the intubated and spontaneously breathing patient in the intensive care unit. Acta Anaesthesiol Scand 28: 640–643

    Article  PubMed  CAS  Google Scholar 

  7. Boulard G, Maurette P, Pouguet P et al (1983) Syndrome d’abstinence après arrêt de la sédation par fentanyl en neuro-réanimation. Ann Fr Anesth Réanim 2: 101–101

    Google Scholar 

  8. Bovill JG, Sebel PS, Blackburn CL, Heykants J (1982) The pharmacokinetics of alfentanil (R 39209): A new opioid analgesic. Anesthesiology 57: 439–443

    Article  PubMed  CAS  Google Scholar 

  9. Bower S (1982) Plasma protein binding of fentanyl: The effect of hyperlipoproteinaemia and chronic renal failure. J Pharm Pharmacol 34: 102–106

    Article  PubMed  CAS  Google Scholar 

  10. Brockmüller KD, Schwenzer N (1973) Ein neuer Weg zur Schmerzausschaltung bei extraoralen Abszeßeröffnungen. Dtsch Zahnärztl Z 28: 1004

    PubMed  Google Scholar 

  11. Bromm B (Hrsg) (1984) Pain measurement in man. Neurophysiological correlates of pain. Elsevier, Amsterdam

    Google Scholar 

  12. Bullingham RES, McQuay HJ, Moore RA (1983) Clinical pharmacokinetics of narcotic agonist-antagonist drugs. Clin Pharmacokinet 8: 332–343

    Article  PubMed  CAS  Google Scholar 

  13. Campbell D (1967) Pain relief in patients on ventilators. Br J Anaesth 39: 736–742

    Article  PubMed  CAS  Google Scholar 

  14. Chauvin M, Bonnet F, Montembault C, Levron JC, Viars P (1986) The influence of hepatic plasma flow on alfentanil plasma concentration plateaus achieved with an infusion model in humans: Measurements of alfentanil hepatic extraction coefficient. Anesth Analg 65: 999–1003

    Article  PubMed  CAS  Google Scholar 

  15. Chauvin M, Lebrault C, Levron JC, Duvaldestin P (1987) Pharmacokinetics of alfentanil in chronic renal failure. Anesth Analg 66: 53–56

    Article  PubMed  CAS  Google Scholar 

  16. Chauvin M, Sandouk P, Scherrmann JM, Farinotti R, Strumza P, Duvaldestin P (1987) Morphine pharmacokinetics in renal failure. Anesthesiology 66: 327–331

    Article  PubMed  CAS  Google Scholar 

  17. Chrubasik J, Falke K, Zindler M, Geller E, Niv D, Friedrich G, Schulte-Mönting J (1986) Indication for pulmonary metabolism of morphine? Schmerz Pain Douleur 7: 36–38

    Google Scholar 

  18. Chrubasik J, Geller E, Niv D, Zindler M (1987) Morphine inhalation versus intravenous infusion in pain treatment after abdominal surgery. Anesth Analg 66: S29

    Article  Google Scholar 

  19. Church JJ (1979) Continuous narcotic infusions for relief of postoperative pain. Br Med J 6: 977–978

    Article  Google Scholar 

  20. Cohen AT, Kelly DR (1987) Assessment of alfentanil by intravenous infusion as long-term sedation in intensive care. Anaesthesia 42: 545–548

    Article  PubMed  CAS  Google Scholar 

  21. Corall IM, Moore RA, Strunin L (1980) Plasma concentrations of fentanyl in normal surgical patients and those with severe renal and hepatic disease. Br J Anaesth 52: 101 P

    Google Scholar 

  22. Dahlström B, Tamsen A, Paalzow L, Hartvig P (1982) Patient-controlled analgesic therapy, part IV: Pharmacokinetics and analgesic plasma concentrations of morphine. Clin Pharmacokinet 7: 266–279

    Article  PubMed  Google Scholar 

  23. Dick W, Knoche E, Grundlach G, Klein I (1983) Klinisch experimentelle Untersuchungen zur postoperativen Infusionsanalgesie. Anaesthesist 32: 272–278

    PubMed  CAS  Google Scholar 

  24. Doenicke A (1986) Langzeitsedierung des Intensivpatienten–Behandlung mit Opioiden. In: Schulte am Esch J (Hrsg) Langzeitsedierung des Intensivpatienten. Zuckschwerdt, München, S 14–26

    Google Scholar 

  25. Don HF, Dieppa RA, Taylor P (1975) Narcotic analgesics in anuric patients. Anesthesiology 42: 745–747

    Article  PubMed  CAS  Google Scholar 

  26. Duthie DJR, McLaren AD, Nimmo WS (1986) Pharmacokinetics of fentanyl during constant rate i. v. infusion for the relief of pain after surgery. Br J Anaesth 58: 950–956

    Article  PubMed  CAS  Google Scholar 

  27. Ferrier C, Marty J, Bouffard Y, Haberer P, Levron JC, Duvaldestin P (1985) Alfentanil pharmacokinetics in patients with cirrhosis. Anesthesiology 62: 480–484

    Article  PubMed  CAS  Google Scholar 

  28. Fragen RJ, Booij LHDJ, Braak GJJ, Vree TB, Heykants J, Crul JF (1983) Pharmacokinetics of the infusion of alfentanil in man. Br J Anaesth 55: 1077–1081

    Article  PubMed  CAS  Google Scholar 

  29. Haberer JP, Schoeffler P, Couderc E, Duvaldestin P (1982) Fentanyl pharmacokinetics in anaesthetized patients with cirrhosis. Br J Anaesth 54: 1267–1270

    Article  PubMed  CAS  Google Scholar 

  30. Harmer M, Rosen M, Vickers MD (eds) (1985) Patient-controlled analgesia. Blackwell, Oxford

    Google Scholar 

  31. Hartenauer U (1982) Medikamentöse Sedierung während Langzeitbeatmung. In: Lawin P, Götz E, Huth H (Hrsg) Intravenöse Narkose und Langzeitsedierung. Thieme, Stuttgart New York, S 106–116

    Google Scholar 

  32. Hengstmann JH, Stoeckel H, Schüttler J (1978) Pharmacokinetics of fentanyl - evaluation of an infusion model. Naunyn Schmiedebergs Arch Pharmacol [Suppl] 302: 252

    Google Scholar 

  33. Hengstmann JH, Stoeckel H, Schüttler J (1980) Infusion model for fentanyl based on pharmacokinetic analysis. Br J Anaesth 52: 1021–1025

    Article  PubMed  CAS  Google Scholar 

  34. Hess R, Husmann K, Kettler D (1981) Blood levels of fentanyl during multiple injections and intravenous infusions of low and high doses: Approaching optimal conditions for “stress-free anaesthesia” Methods Find Exp Clin Pharmacol [Suppl] 3: 107S - 1145

    Google Scholar 

  35. Heuser D, Kottler B, Guggenberger H, Wagener B, Weigand H, Nieratschker I (1986) Aktuelle Aspekte zur Sedierungsproblematik bei Beatmungspatienten. Vortrag beim Internationalen Bremer Anästhesie Symposion, 17.-19. 4. 1986

    Google Scholar 

  36. Hoffmann P (1987) Kombination von Benzodiazepinen und Opioiden in der Intensivmedizin. Anaesthesist [Suppl] 36: 201

    Google Scholar 

  37. Hug CC (1984) Pharmacokinetics and dynamics of narcotic analgesics. In: Prys-Roberts C, Hug CC (eds) Pharmacokinetics of anaesthesia. Blackwell, Oxford, pp 187–234

    Google Scholar 

  38. Hynynen M, Takkunen O, Salemnperä M, Haataja H, Heinonen J (1986) Continuous infusion of fentanyl or alfentanil for coronary artery surgery. Plasma opiate concentrations, haemodynamics and postoperative course. Br J Anaesth 58: 1252–1259

    Article  PubMed  CAS  Google Scholar 

  39. Kang YG, Uram M, Shiu GK, Bleyaert A, Martin J, Nemoto E, Starzl T (1984) Pharmacokinetics of fentanyl in end-stage liver disease. Anesthesiology 61: A380

    Article  Google Scholar 

  40. Keeri-Szanto M (1980) The kinetics of postoperative analgesia. Clin Pharmacol Ther 27: 263

    Google Scholar 

  41. Kobal G (1985) Pain-related electrical potentials of the human nasal mucosa elicited by chemical stimulation. Pain 22: 151–163

    Article  PubMed  CAS  Google Scholar 

  42. Kobal G, Kamp HD (1985) Analgesimetry during anaesthesia using pain-related chemosomatosensory evoked potentials. Anaesthesist [Supp1]34: 47

    Google Scholar 

  43. Kochs E, Bause H (1986) Wirkungen von Langzeitsedierung auf Hormone des Hypophysen-NNR-Systems. In: Schulte am Esch J (Hrsg) Langzeitsedierung des Intensivpatienten. Zuckschwerdt, München, S 55–65

    Google Scholar 

  44. Kochs E, Schulte am Esch J (1984) Hormone des Hypophysen-Nebennierenrindensystems bei Patienten unter Langzeitsedierung mit Etomidate und Fentanyl. Anaesthesist 33: 402–407

    PubMed  CAS  Google Scholar 

  45. Kurth M (1983) Anästhesie und Analgosedierung mit Ketamin bei Patenten einer Intensivstation. Anästh Intensivmed 24: 270–272

    Google Scholar 

  46. Lauven PM, Stoeckel H, Schüttler J (1982) Zur Pharmakokinetik der intravenösen Narkotika. In: Lawin P, Götz E, Huth H (Hrsg) Intravenöse Narkose und Langzeitsedierung. Thieme, Stuttgart New York, S 10–19

    Google Scholar 

  47. Lehmann KA (1984) On-Demand Analgesie: Neue Möglichkeiten zur Behandlung akuter Schmerzen. Arzneimittel Forsch 34: 1108–1114

    CAS  Google Scholar 

  48. Lehmann KA (1985) The pharmacokinetics of opioid analgesics (discussion). In: Harmer M, Rosen M, Vickers MD (eds) Patient-controlled analgesia. Blackwell, Oxford, pp 18–29

    Google Scholar 

  49. Lehmann KA (1986) Pharmakokinetik: Gibt es analgetische Blutkonzentrationen? In: Kettler D, Crozier T, Metzler H (Hrsg) Analgesie in der Anästhesie. Stellenwert der Morphinomimetika. Urban & Schwarzenberg, München, S 28–39

    Google Scholar 

  50. Lehmann KA, Gensior J, Daub D (1982) „Analgetische“ Fentanyl-Blutkonzentrationen unter Neuroleptanalgesie. Anaesthesist 31: 655–659

    Google Scholar 

  51. Mather LE (1983) Pharmacokinetic and pharmacodynamic factors influencing the choice, dose and route of administration of opiates for acute pain. In: Bullingham RES (ed) Opiate analgesia. Saunders, London (Clinics in Anaesthesiology, vol 1, no 1, pp 17–40 )

    Google Scholar 

  52. Mather LE (1983) Clinical pharmacokinetics of fentanyl and its newer derivatives. Clin Pharmacokinet 8: 422–446

    Article  PubMed  CAS  Google Scholar 

  53. McDonnell TE, Bartkowski RR, Bonilla FA, Henthorn TK, Williams JJ (1982) Nonuniformity of alfentanil pharmacokinetics in healthy adults. Anesthesiology 57: A236

    Article  Google Scholar 

  54. McQuay HJ, Moore A (1984) Be aware of renal function when prescribing morphine. Lancet 11: 384–385

    Google Scholar 

  55. McQuay HJ, Moore RA, Paterson GMC, Adams AP (1979) Plasma fentanyl concentrations and clinical observations during and after operation. Br J Anaesth 51: 543–550

    Article  PubMed  CAS  Google Scholar 

  56. Merriman HM (1981) The techniques used to sedate ventilated patients. A survey of methods used in 34 ICUs in Great Britain. Intensive Care Med 7: 217–224

    Article  PubMed  CAS  Google Scholar 

  57. Miller-Jones CMH, Williams JH (1980) Sedation for ventilation. A retrospective study of fifty patients. Anaesthesia 35: 1104–1107

    Article  PubMed  CAS  Google Scholar 

  58. Moore RA, Sear W, Bullingham RES, McQuay HJ (1986) Morphine kinetics in renal failure. In: Foley KM, Inturrisi CE (eds) Advances in pain research and therapy, vol 8. Raven, New York, pp 65–72

    Google Scholar 

  59. Morgan RJM (1983) Rapid and safe withdrawal of intravenous papaveretum after prolonged continuous infusion. Anaesthesia 38: 492–494

    PubMed  CAS  Google Scholar 

  60. Mostert JW, Evers JL, Hobika GH, Moore RH, Ambrus JL (1971) Cardiorespiratory effects of anaesthesia with morphine or fentanyl in chronic renal failure and cerebral toxicity after morphine. Br J Anaesth 43: 1053–1059

    Article  PubMed  CAS  Google Scholar 

  61. Murrin KR, Rosen M (1985) Pain measurement. In: Smith G, Covino BG (eds) Acute pain. Butterworths, London, pp 104–132

    Google Scholar 

  62. Nassery W (1981) Plastische Chirurgie unter Analgosedierung. Z Plast Chir 5: 143–149

    PubMed  CAS  Google Scholar 

  63. Nimmo WS, Todd JG (1985) Fentanyl by constant rate i. v. infusion for postoperative analgesia. Br J Anaesth 57: 250–254

    Article  PubMed  CAS  Google Scholar 

  64. Norman J (1983) The i. v. administration of drugs. Br J Anaesth 55: 1049–1052

    Article  PubMed  CAS  Google Scholar 

  65. O’Connor M, Escarpa A, Prys-Roberts C (1983) Ventilatory depression during and after infusion of alfentanil in man. Br J Anaesth 55: 217S - 222S

    PubMed  Google Scholar 

  66. O’Connor M, Prys-Roberts C, Sear JW (1987) Alfentanil infusions: Relationship between pharmacokinetics and pharmacodynamics in man. Eur J Anaesth 4: 187–196

    Google Scholar 

  67. O’Dea J, Hopkinson R (1987) Alfentanil-midazolam infusion. Care Crit III 3: 20–21

    Google Scholar 

  68. Rawal N, Tandon B (1985) Epidural and intrathecal morphine in intensive care units. Intensive Care Med 11: 129–133

    Article  PubMed  CAS  Google Scholar 

  69. Regnard CFB, Twycross RG (1984) Metabolism of narcotics. Br Med J 288: 860

    Article  CAS  Google Scholar 

  70. Reyes JG, Spain JA, Alvis JM, Ritchie RG (1984) Continuous infusion of fentanl during cardiac anesthesia: An automated system. Anesth Analg 63: 266

    Google Scholar 

  71. Rietbrock I (1982) Elimination und Wirkungsverlust intravenöser Narkotika. In: Lawin P, Götz E, Huth H (Hrsg) Intravenöse Narkose und Langzeitsedierung. Thieme, Stuttgart New York, S 29–41

    Google Scholar 

  72. Schulte am Esch J (1986) Ruhigstellung des Intensivpatienten–Sedierung oder Narkose? In: Schulte am Esch J (Hrsg) Langzeitsedierung des Intensivpatienten. Zuckschwerdt, München, S 1–6

    Google Scholar 

  73. Schüttler J, Stoeckel H, Schwilden H, Lauven PM (1983) Pharmakokinetisch begründete Infusionsmodelle für die Narkoseführung mit Alfentanil. Anaesthesist 32: 316–317

    Google Scholar 

  74. Schüttler J, Schwilden H, Stoeckel H (1986) Adaptive dosing strategies for alfentanil by computercontrolled infusion regimens. Eur J Anaesth 3: 67–68

    Google Scholar 

  75. Schwilden H, Stoeckel H, Schüttler J, Lauven PM (1986) Pharmacological models and their use in clinical anaesthesia. Eur J Anaesth 3: 175–208

    CAS  Google Scholar 

  76. Sear JW (1983) General kinetic and dynamic principles and their application to continuous infusion anaesthesia. Anaesthesia [Suppl] 38: 10–25

    CAS  Google Scholar 

  77. Sear J, Moore A, Hunniset A et al (1985) Morphine kinetics and kidney transplantation: Morphine removal is influenced by renal ischemia. Anesth Analg 64: 1065–1070

    Article  PubMed  CAS  Google Scholar 

  78. Sear JW, Bower S, Potter D (1986) Disposition of alfentanil in patients with chronic renal failure. Br J Anaesth 58: 812 P

    Google Scholar 

  79. Shafer A, White PF, Schüttler J, Rosenthal MH (1983) Use of a fentanyl infusion in the intensive care unit: Tolerance to its anesthetic effects? Anesthesiology 59: 245–248

    PubMed  CAS  Google Scholar 

  80. Shafer A, Sung ML, White PF (1985) Differences in pharmacokinetics contribute to postoperative respiratory depression after an alfentanil infusion. Anesthesiology 63: A283

    Article  Google Scholar 

  81. Shafer A, Sung ML, White PF (1986) Pharmacokinetics and pharmacodynamics of alfentanil infusions during general anesthesia. Anesth Analg 65: 1021–1028

    Article  PubMed  CAS  Google Scholar 

  82. Shelly MP, Cory EP, Park GR (1986) Pharmacokinetics of morphine in two children before and after liver transplantation. Br J Anaesth 58: 1218–1223

    Article  PubMed  CAS  Google Scholar 

  83. Sitar DS, Duke PC, Owen JA, Mitenko PA (1986) Kinetic disposition of morphine in young males after intravenous loading and maintenance infusions. Can Anaesth Soc J 33: 145–149

    Article  PubMed  CAS  Google Scholar 

  84. Sprigge JM, Wynands JE, Whalley D, Bevan D, Nathan GE, Townsend GE, Patel Y (1982) Haemodynamic reponses and serum fentanyl levels during fentanyl. Can Anaesth Soc J 29: 495

    Article  Google Scholar 

  85. Sprigge JS, Wynands JE, Whalley DG et al (1982) Fentanyl infusion anesthesia for aortocoronary bypass surgery: Plasma levels and hemodynamic response. Anesth Analog 61: 972–978

    Article  CAS  Google Scholar 

  86. Sprigge JS, East DSR, Fox GS, Ogilvie RI, Otton PE, Bevan DR (1982) Meperidine infusion for postoperative analgesia in grossly obese patients. Can Anaesth Soc J 29: 142–147

    Article  PubMed  CAS  Google Scholar 

  87. Stapleton JV, Austin KL, Mather LE (1979) A pharmacokinetic approach to postoperative pain: Continuous infusion of pethidine. Anaesth Intensive Care 7: 25–32

    PubMed  CAS  Google Scholar 

  88. Stoeckel H, Oyama T (eds) (1980) Endocrinology in anaesthesia and surgery. Springer, Berlin Heidelberg New York (Anaesthesiologie und Intensivmedizin, Bd 132 )

    Google Scholar 

  89. Tamsen A, Hartvig P, Fagerlund C, Dahlström B (1982) Patient-controlled analgesic therapy, part II: Individual analgesic demand and analgesic plasma concentrations. Clin Pharmacokinet 7: 164–175

    Article  PubMed  CAS  Google Scholar 

  90. Tamsen A, Bondesson U, Dahlström B, Hartvig P (1982) Patient-controlled analgesic therapy, part III: Pharmacokinetics and analgesic plasma concentrations of ketobemidone. Clin Pharmacokinet 7: 252–265

    Article  PubMed  CAS  Google Scholar 

  91. Vogel W (1966) Über die Langzeitbehandlung mit Fentanyl und Dehydrobenzperidol. In: Gemperle M (Hrsg) Fortschritte der Neuroleptanalgesie. Springer, Berlin Heidelberg New York (Anaesthesiologie und Wiederbelebung, Bd 18, S 87–89 )

    Google Scholar 

  92. Voigt E (1975) Analgosedierung in der Hals-Nasen-Ohrenheilkunde bei operativen Eingriffen in Lokalanaästhesie. Prakt Anästh 10: 93–98

    Google Scholar 

  93. Vontin H, Heller W, Schorer R (1975) Analgosedierung und Ataranalgesie: Untersuchungen über „Rohypnol“ und Kombinationen mit Analgetika. In: Hügin W, Hossli G, Gemperle M (Hrsg) Bisherige Erfahrungen mit Rohypnol (Flunitrazepam) in der Anästhesiologie und Intensivtherapie. Editiones Roches, Basel, S 149–160

    Google Scholar 

  94. Wagner JG (1974) A safe method for rapidly achieving plasma concentration plateaus. Clin Pharmacol Ther 16: 691–700

    PubMed  CAS  Google Scholar 

  95. Waldmann CS, Eason JR, Rambohul E, Hanson GC (1984) Serum morphine levels. A comparison between continuous subcutaneous infusion and continuous intravenous infusion in postoperative patients. Anaesthesia 39: 768–771

    Article  PubMed  CAS  Google Scholar 

  96. Wendt M (1982) Probleme bei der Entwöhnung nach Langzeitsedierung. In: Lawin P, Götz E, Huth H (Hrsg) Intravenöse Narkose und Langzeitsedierung. Thieme, Stuttgart New York, S 117–122

    Google Scholar 

  97. White PF, Sung ML (1985) Use of opiate infusions in anesthesia - determining optimal doses and serum concentrations. Anesth Analg 64: 299

    Google Scholar 

  98. White PF, Dworsky WA, Horai Y, Trevor AJ (1983) Comparison of continuous infusion fentanyl or ketamine versus thiopental–determining the mean effective serum concentrations for outpatient surgery. Anesthesiology 59: 564–569

    Article  PubMed  CAS  Google Scholar 

  99. Yate PM, Thomas D, Sebel PS (1984) Alfentanil infusion for sedation and analgesia in intensive care. Lancet II: 396–397

    Google Scholar 

  100. Yale PM, Thomas D, Short SM, Sebel PS, Morton J (1986) Comparison of infusions of alfentanil or pethidine for sedation of ventilated patients on the ICU. Br J Anaesth 58: 1091–1099

    Article  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1988 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Lehmann, K.A. (1988). Analgosedierung mit Opioiden. In: Schulte am Esch, J., Benzer, H. (eds) ZAK München 1987. Anaesthesiologie und Intensivmedizin / Anaesthesiology and Intensive Care Medicine, vol 200. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-73678-0_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-73678-0_3

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-19252-7

  • Online ISBN: 978-3-642-73678-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics