Skip to main content
SpringerLink
Log in

Besonderheiten der Narkoseführung im Alter, speziell in der Gefäßchirurgie

  • Chapter
Der geriatrische Patient in der Anaesthesie

Zusammenfassung

Der Wandel der Altersstruktur im operativen Bereich läßt sich eindrucksvoll und beispielhaft an 4 Publikationen der letzten 80 Jahre widerspiegeln [1, 6, 11,27]. Eine der frühesten Arbeiten aus dem Jahre 1907 berichtet über 167 Operationen an Patienten älter als 50 Jahre [27]. Die Autoren kamen zu dem Ergebnis, daß ein Alter von 50 Jahren und darüber eine Kontraindikation für ein operatives Vorgehen darstellt. 20 Jahre später publizierte Brooks eine Arbeit über 293 Operationen bei Patienten älter als 70 Jahre [1].

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

Access this chapter

Log in via an institution
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. Brooks B (1937) Surgery in patients of advanced age. Ann Surg 105:481–495

    Article  PubMed  CAS  Google Scholar 

  2. Callow AD, Matsumoto G, Baker D, Cossmann D, Watson W (1978) Protection of the high risk carotid endarterectomy patient by continous electroencephalography. J Cardio- vasc Surg 19:55–63

    CAS  Google Scholar 

  3. Connolly JE (1985) Carotid endarterectomy in the awake patient. Am J Surg 150:159–165

    Article  PubMed  CAS  Google Scholar 

  4. Davies M, Murrell GG, Cronin KD, Meads AC, Dawson A (in press) Carotid endarterectomy under cervical plexus bloc

    Google Scholar 

  5. Denney JL, Denson JS (1972) Risk of surgery in patients over 90. Geriatrics 27:115–118

    PubMed  CAS  Google Scholar 

  6. Djokovic JL, Hedley-Whyte J (1979) Prediction of out-come of surgery and anesthesia in patients over 80. JAMA 242:2304–2306

    Article  Google Scholar 

  7. Ellis JE, Roizen MF, Aronson S, Feinstein SB, Briller JE (1987) Frequency with which ST- segment trends predict intraoperative myocardial ischemia. Anesthesiology 67:A2

    Article  Google Scholar 

  8. Goehner P, Hollenberg M, Leung J, Browner W, Cason B, Mangano DT (1988) Hemodynamic control suppresses myocardial ischemia during isoflurane or sufentanil anesthesia for CABG. Anesthesiology 69:A32

    Article  Google Scholar 

  9. Hafner CD, Evans WE (1988) Carotid endarterectomy with local anesthesia: Results and advantages. J Vasc Surg 7:232–239

    PubMed  CAS  Google Scholar 

  10. Hertzer NR, Beven EG, Young JR et al. (1984) Coronary artery disease in peripheral vascular patients. Ann Surg 199:223–233

    Article  PubMed  CAS  Google Scholar 

  11. Hosking MP, Warner MA, Lobdell CM, Offord KP, Melton LJ (1989) Outcomes of surgery in patients 90 years of age and older. JAMA 261:1909–1915

    Article  PubMed  CAS  Google Scholar 

  12. Knight AA, Hollenberg M, London MJ, Tubau J, Verrier E (1988) Perioperative myocardial ischemia: Importance of the preoperative ischemic pattern. Anesthesiology 68:681–688

    Article  PubMed  CAS  Google Scholar 

  13. Kortmann H, Becker HM (1985) Bauchaortenaneurysmen: Diagnostische und chirurgische Probleme im höheren Alter. Z Gerontol 18:44–47

    PubMed  CAS  Google Scholar 

  14. London MJ, Hollenberg M, Wong MG, Levenson L, Tubau JF, Browner W, Mangano DT (1988) Intraoperative myocardial ischemia: Localization by continuous 12-lead electrocardiography. Anesthesiology 69:232–241

    Article  PubMed  CAS  Google Scholar 

  15. Mangano DT (1989) Anesthetics, coronary artery disease, and outcome: Unresolved controversies. Anesthesiology 70:175–178

    Article  PubMed  CAS  Google Scholar 

  16. Mashiah A, Sovoker D, Pasik S, Mashiah T (1988) Carotid surgery under local anesthesia in the elderly. J Am Geriatr Soc 36:545–547

    PubMed  CAS  Google Scholar 

  17. McCann RL, Clements FM (1989) Silent myocardial ischemia in patients undergoing peripheral vascular surgery: Incidence and association with perioperative cardiac morbidity and mortality. J Vasc Surg 9:583–587

    PubMed  CAS  Google Scholar 

  18. McFarland HR, Pinkerton JA, Freye D (1988) Continous electroencephalographic monitoring during carotid endarterectomy. J Cardiovasc Surg 29:12–18

    CAS  Google Scholar 

  19. Peitzman AB, Webster MW, Lonbeau JM, Grundy B, Bahnson H (1982) Carotid endarterectomy under regional (conductive) anesthesia. Ann Surg 196:59–64

    Article  PubMed  CAS  Google Scholar 

  20. Pluskwa F, Bonnet F, Touboul C, Szekely B, Roujas F, Becquemin JP (1988) En- dartérectomie carotidienne sous anesthésie péridurale cervicale analyse des événements neurologiques. Ann Fr Anesth Réanim 7:36–41

    Article  PubMed  CAS  Google Scholar 

  21. Russ W, Fraedrich G, Hehrlein FW, Hempelmann G (1985) Intraoperative somatosensory evoked potentials as a prognostic factor of neurologic state after carotid endarterectomy. Thorac Cardiovasc Surg 33:392–396

    Article  PubMed  CAS  Google Scholar 

  22. Rutkow JM, Ernst CB (1986) An analysis of vascular surgical manpower requirements and vascular surgical rates in the United States. J Vasc Surg 3:47–83

    Google Scholar 

  23. Slogoff S, Keats AS (1985) Does perioperative myocardial ischemia lead to postoperative myocardial infarction? Anesthesiology 62:107–114

    Article  PubMed  CAS  Google Scholar 

  24. Slogoff S, Keats AS (1988) Does chronic treatment with calcium entry blocking dugs reduce perioperative myocardial ischemia. Anesthesiology 68:676–680

    Article  PubMed  CAS  Google Scholar 

  25. Slogoff S, Keats AS (1986) Further observations on perioperative myocardial ischemia. Anesthesiology 65:539–542

    Article  PubMed  CAS  Google Scholar 

  26. Slogoff S, Keats AS (1989) Randomized trial of primary anesthetics agents on out-come of coronary artery bypass operations. Anesthesiology 70:179–188

    Article  PubMed  CAS  Google Scholar 

  27. Smith OC (1907) Advanced age as contraindication to operation. Med Rec (NY) 72:642–644

    Google Scholar 

  28. Smith JS, Cahalan MB, Benefìel DJ et al. (1985) Intraoperative detection of myocardial ischemia in high-risk patients. Electrocardiography versus two dimensional transoesophageal echocardiography. Circulation 72:1015–1021

    Article  PubMed  CAS  Google Scholar 

  29. Smith JS, Roizen MF, Cahalan MB et al. (1989) Doas anesthetic technique make a difference? Augmentation of systolic blood pressure during carotid endarterectomy effects of phenylephrine versus light anesthesia and of isoflurane versus halothane on the incidence of myocardial ischemia. Anesthesiology 69:846–853

    Article  Google Scholar 

  30. Sundt TM, Shrabrough FW, Piepgras DG (1981) Correlation of cerebral blood flow and electroencephalographic changes during carotid endarterectomy. Mayo Clin Proc 56:533–543

    PubMed  Google Scholar 

  31. Sundt TM, Ebersold MJ, Sharbrough FW, Piepgras DG, Marsh WR, Messick JM (1986) The risk-benefit ratio of intraoperative shunting during carotid endarterectomy. Ann Surg 203:196–204

    Article  PubMed  Google Scholar 

  32. Thiel A, Russ W, Nestle HW, Hempelmann G (1989) Early detection of cerebral ischemia during carotid endarterectomy using transcranial Doppler Sonography and Somatosensory evoked potentials. Thorac Cardiovasc Surg 37:115–118

    Article  PubMed  CAS  Google Scholar 

  33. Tuman K, McCarthy RJ, Spiess BD, Da Valle M, Dabir R, Ivankovich AD (1989) Does choice of anesthetic agent significantly affect outcome after coronary surgery. Anesthesiology 70:189–198

    Article  PubMed  CAS  Google Scholar 

  34. Unertl K, Wroblewski H, Glükher S, Heinrich G, Rauch M, Peter K (1985) Das Risiko in der Anästhesie. Münch Med Wochenschr 127:218–224

    Google Scholar 

  35. Werner C, Kochs E, Rau M, Blaue J, Schulte am Esch J (1986) Steigerung der Blutflußgeschwindigkeit in der Arteria cerebri media nach low-dose Ketamin. Anästh Intensivther Notfallmed 24:231–235

    Article  Google Scholar 

  36. Zuccarello M, Yeh H, Tew JM (1988) Morbidity and mortality of carotid endarterectomy under local anesthesia: a retrospective study. Neurosurgery 23:445–450

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. E. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. U. Zaune
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Boeden
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Institut für Anästhesiologie und Operative Intensivmedizin, Fakultät für Klinische Medizin Mannheim, der Universität Heidelberg, Klinikum Mannheim, Theodor-Kutzer-Ufer, D-6800, Mannheim, Germany

    Klaus van Ackern  & Michael Albrecht  & 

  2. Institut für Anästhesie der Universität Graz, Landeskrankenhaus, Auenbruggerplatz, A-8036, Graz, Austria

    Werner F. List

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Martin, E., Zaune, U., Boeden, G. (1991). Besonderheiten der Narkoseführung im Alter, speziell in der Gefäßchirurgie. In: van Ackern, K., Albrecht, M., List, W.F. (eds) Der geriatrische Patient in der Anaesthesie. Anaesthesiologie und Intensivmedizin Anaesthesiology and Intensive Care Medicine, vol 217. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76317-5_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-76317-5_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-53506-5

  • Online ISBN: 978-3-642-76317-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation