Supplementierung der Regionalanästhesie durch intravenöse Anästhesie

  • P. G. Atanassoff
  • E. Alon
  • T. Pasch
Conference paper
Part of the Klinische Anästhesiologie und Intensivtherapie book series (KAI, volume 44)

Zusammenfassung

Die Regionalanästhesie spielt eine zunehmend wichtige Rolle in der modernen Anästhesie. Mehr und mehr Anästhesisten erkennen die Vorteile regionalanästhesiologischer Techniken. Darunter fallen in erster Linie die Beibehaltung des Bewußtseins und der protektiven Reflexe der Patienten wie auch eine je nach verwendetem Lokalanästhetikum verschieden weit in die postoperative Phase anhaltende Analgesie. Zusätzlich zur Entwicklung von Lokalanästhetika wie auch der Ausrüstung sind im Zusammenhang mit regionalanästhesiologischen Techniken erhebliche Fortschritte auf dem Gebiet der perioperativen Sedierung erzielt worden. Ziel dieser Sedierung soll es sein, dem Patienten Angst, Spannung, Unruhe und motorische Agitiertheit während des operativen Eingriffs zu nehmen. Im Fall einer nicht ausreichenden Analgesie können als Supplementierung niedrig dosierte Opiate bzw. Ketamin in Frage kommen; dies kann und darf jedoch nicht primäres Ziel sein.

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Literatur

  1. 1.
    Adams AP, Pybus DA (1978) Delayed respiratory depression after use of fentanyl during anaesthesia. Br Med J 1: 278–279PubMedCrossRefGoogle Scholar
  2. 2.
    Baird ES, Hailey DM (1972) Delayed recovery from a sedative. Correlation of the plasma levels of diazepam with clinical effects after oral and intravenous administration. Br J Anaesth 44: 803–808Google Scholar
  3. 3.
    Berggren L, Eriksson I (1981) Midazolam for induction of anaesthesia in outpatients: a comparison with thiopentone. Acta Anaesthesiol Scand 25: 492–496PubMedCrossRefGoogle Scholar
  4. 4.
    Bond AJ, Hailey DM, Lader MH (1977) Plasma concentrations of benzodiazepines. Br J Clin Pharmacol 4: 51–56PubMedGoogle Scholar
  5. 5.
    Caplan RA,Ward RJ, Ed M, Posner K, Cheney FW (1988) Unexpected cardiac arrest during spinal anesthesia: a closed claims analysis of predisposing factors. Anesthesiology 68: 5–11CrossRefGoogle Scholar
  6. 6.
    Dundee JW, Pandit SK (1972) Anterograde amnesic effects of pethidine, hyoscine and diazepam in adults. Br J Pharmacol 44: 140–144PubMedGoogle Scholar
  7. 7.
    Dundee JW, Wilson DB (1980) Amnesic action of midazolam. Anaesthesia 35: 459–461PubMedCrossRefGoogle Scholar
  8. 8.
    Dundee JW,Wyant GM (1988) Intravenous anaesthesia, 2nd edn. Livingstone, Edinburgh, pp 184–205Google Scholar
  9. 9.
    Dundee JW, Varadarajan CR, Gaston JH, Clarke RSJ (1976) Clinical studies of induction agents. XLIII: Flunitrazepam. Br J Anaesth 48: 551–555Google Scholar
  10. 10.
    Gjessing J,Tomlin PJ (1977) Intravenous sedation and regional anaesthesia. Anaesthesia 32: 63–69CrossRefGoogle Scholar
  11. 11.
    Greenblatt DJ, Shader RI, Abernethy DR, Ochs HR, Divoll M, Sellers EM (1982) Benzodiazepines and the challenge of pharmacokinetic taxonomy. In: Usdin E, Skolnick P, Tallman JF, Greenblatt D, Paul SM (eds) Pharmacology of benzodiazepines. Macmillan, London, pp 257–269Google Scholar
  12. 12.
    Greenblatt DJ, Abernethy DR, Locniskar A, Harmatz JS, Limjuco RA, Shader RI (1984) Effect of age, gender, and obesity on midazolam kinetics. Anesthesiology 61: 27–35PubMedGoogle Scholar
  13. 13.
    Grounds RM, Morgan M, Lumley L (1985) Some studies on the properties of the intravenous anesthetic propofol - a review. Postgrad Med J 61 (Suppl 3): 90–95PubMedGoogle Scholar
  14. 14.
    Kay NH, Uppington J, Sear JW, Douglas EJ, Cockshott ID (1985) Pharmakokinetics of propofol as an induction agent. Postgrad Med J 61 (Suppl 3): 55–57PubMedGoogle Scholar
  15. 15.
    Kortilla K, Linnoila M (1976) Amnesic action and skills related to driving after intravenous flunitrazepam. Acta Anaesthesiol Scand 20: 160–168CrossRefGoogle Scholar
  16. 16.
    Langa H (1968) Relative analgesia in dental practice. Saunders, PhiladelphiaGoogle Scholar
  17. 17.
    Lee JA (1964) The management of the patient under peridural anesthesia. Int Anesthesiol Clin 2: 499–505PubMedCrossRefGoogle Scholar
  18. 18.
    Mackenzie N, Grant IS (1985) Comparison of propofol with methohexitone in the provision of anaesthesia for surgery under regional blockade. Br J Anaesth 57: 1167–1172PubMedCrossRefGoogle Scholar
  19. 19.
    McClure JH, Brown DT,Wildsmith JAW (1983) Comparison of the iv administration of midazolam and diazepam as sedation during spinal anaesthesia. Br J Anaesth 55: 1089–1093Google Scholar
  20. 20.
    Möhler H, OkadaT (1978) The benzodiazepine receptor in normal and pathological human brain. Br J Psychiat 133: 261–268Google Scholar
  21. 21.
    Parbrook GD, Still DM, Parbrook EO (1989) Comparison of iv sedation with midazolam and inhalational sedation with isoflurane in dental out patients. Br J Anaesth 63: 81–86PubMedCrossRefGoogle Scholar
  22. 22.
    Thornton JA, Martin VC (1976) Flunitrazepam in dental outpatients. Anaesthesia 31: 297PubMedCrossRefGoogle Scholar
  23. 23.
    Tinker JH, Dull DL, Caplan RA, Ward RJ, Cheney FW (1989) Role of monitoring devices in prevention of anesthetic mishaps: a closed claims analysis. Anesthesiology 71: 541–546PubMedCrossRefGoogle Scholar
  24. 24.
    White PF,Way WL, Trevor AJ (1982) Ketamine - its pharmacology and therapeutic uses. Anesthesiology 56: 119–136CrossRefGoogle Scholar
  25. 25.
    Whitwam JG, Al-Khudhairi D, McCloy RF (1983) Comparison of midazolam and diazepam in doses of comparable potency during gastroscopy. Br J Anaesth 55: 773–777PubMedCrossRefGoogle Scholar
  26. 26.
    Wilson E, David A, Mackenzie N, Grant IS (1990) Sedation during spinal anaesthesia: comparison of propofol and midazolam. Br J Anaesth 64: 48–52PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • P. G. Atanassoff
  • E. Alon
  • T. Pasch

There are no affiliations available

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