Advertisement

Überwachung von Analgesie und Sedierung in der postoperativen Phase und in der Intensivmedizin

  • J. Zander
Conference paper
Part of the Klinische Anästhesiologie und Intensivtherapie book series (KAI, volume 44)

Zusammenfassung

Bei der kardiovaskulären und der respiratorischen Therapie von Intensivpatienten ist es selbstverständlich, die Wirkungen und Nebenwirkungen der Therapie und der angewendeten Medikamente zu überwachen, wenn möglich sogar kontinuierlich. Hierzu stehen eine Reihe von invasiven und nichtinvasiven Monitorsystemen zur Verfügung, die entsprechend den individuellen medizinischen Problemen des Patienten abgestuft eingesetzt werden können.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Aldrete JA, Kroulik D (1970) A post-anesthetic recovery score. Anesth Anaig 49: 926Google Scholar
  2. 2.
    Arden JR, Holley FO, Stanski DR (1986) Increased sensitivity to etomidate in the elderly: initial distribution versus altered brain response. Anesthesiology 65: 1927CrossRefGoogle Scholar
  3. 3.
    Ausems ME, Hug CC, de Lange S (1983) Variable rate infusion of alfentanil as a supplement to nitrous oxide anesthesia for general surgery. Anesth Analg 62: 982–986Google Scholar
  4. 4.
    Ausems ME, Vuyk J, Hug CC, Stanski DR (1988) Comparison of a computer-assisted infusion versus intermittent bolus administration of alfentanil as a supplement to nitrous oxide for lower abdominal surgery. Anesthesiology 68: 851–861PubMedCrossRefGoogle Scholar
  5. 5.
    Becker LD, Paulson BA, Miller RD, Severinghaus JW, Eger EI (1976) Biphasic respiratory depression after fentanyl-droperidol or fentanyl alone used to supplement nitrous oxide anesthesia. Anesthesiology 44: 291PubMedCrossRefGoogle Scholar
  6. 6.
    Beran AV, Tolle CD, Huxtable RF (1981) Cutaneous blood flow and its relationship to transcutaneous 02/C02 measurements. Crit Care Med 9: 736PubMedCrossRefGoogle Scholar
  7. 7.
    Bion JF, Logan BK, Newman PM, Brodie MJ, Oliver JS, Aitchinson TC, Ledingham IM (1986) Sedation in intensive care: morphine and renal function. Intens Care Med 12: 359–365CrossRefGoogle Scholar
  8. 8.
    Bodenham A, Park GR (1988) Alfentanil infusions in patients requiring intensive care. Clin Pharmacokinet 15: 216–226PubMedCrossRefGoogle Scholar
  9. 9.
    Bodenham A, Bronwlie G, Dixon JS, Park GR (1988) Reversal of sedation by prolonged infusion of flumazenil (anexate, Ro 15–1788). Anaesthesia 43: 376–378PubMedCrossRefGoogle Scholar
  10. 10.
    Böttger H, Oellerich M, Sybrecht M (1988) Use of aminoglycosides in critically ill patients: individualization or dosage using Bayesian statistics and pharmacokinetic principle. Ther Drug Monit 10: 280–286PubMedCrossRefGoogle Scholar
  11. 11.
    Chauvin M, Sandouk P, Scherrmann JM, Farinotti R, Strumza P, Duvaldestin P (1987) Morphine pharmacokinetics in renal failure. Anesthesiology 66: 327–331PubMedCrossRefGoogle Scholar
  12. 12.
    Chiappa KH, Ropper AH (1982) Evoked potentials in clinical medicine (in two parts). N Engl J Med 306: 1140–1150, 1206–1211Google Scholar
  13. 13.
    Cohen AT, Kelly DR (1987) Assessment of alfentanil by intravenous infusion as long-term sedation in intensive care. Anaesthesia 42: 545–548PubMedCrossRefGoogle Scholar
  14. 14.
    Couture LJ, Edmonds JL (1989) Monitoring responsiveness during anesthesia. In: Jones G (ed) Depth of anaesthesia. Saunders, LondonGoogle Scholar
  15. 15.
    Day BL, Rothwell JC, Thompson PD et al. (1987) Motor unit firing rate during static contraction indicated by the surface EMG power. IEEE Trans Biomed Eng BME 30: 601–608Google Scholar
  16. 16.
    Doenicke A, Suttmann H, Müller OA, Dorow R, DukaT, Hoehe M (1986) Beeinflussung endokrinologischer Parameter durch Narko-Analgetika. In: Doenicke A (Hrsg) Schmerz- eine interdisziplinäre Herausforderung. Springer, Berlin Heidelberg New YorkGoogle Scholar
  17. 17.
    Edmonds HL, Paloheimo MPJ (1991) Intra-operative monitoring of awareness. In: Kay B (ed) Total intravenous anaesthesia. Elsevier, AmsterdamGoogle Scholar
  18. 18.
    Edmonds HL, Couture LJ, Stolzy SL et al. (1986) Quantitative surface electromyography in anesthesia and critical care. Int J Clin Monit Comput 3: 135–145PubMedCrossRefGoogle Scholar
  19. 19.
    Edmonds HL, Stolzy SL, Couture LJ (1987) Surface electromyography during low- vigilance states. In: Rosen M, Lunn JN (eds) Consciousness, awareness and pain in general anesthesia. Butterworths, LondonGoogle Scholar
  20. 20.
    Erdmann K, Brandt L: Klinische Erfahrungen mit einem computerisierten EED-Monitor in der Carotis- und Herzchirurgie. In: Bergmann H, Steinbereithner K (eds) Eur Congr Anaesthesiol Proc. Maudrich, Wien München BernGoogle Scholar
  21. 21.
    Evans JM, White DC. Oesophageal activity and anaesthesia. In: Rosen M, Lunn JN (eds) Consciousness, awareness and pain in general anaesthesia. Butterworths, LondonGoogle Scholar
  22. 22.
    Evans JM, Davies WL,Wise CC (1984) Lower oesophageal contractility: a new monitor of anaesthesia. Lancet I: 1151–1154Google Scholar
  23. 23.
    Gottardis M, Khunl-Brady KS, Koller W, Sigl G, Hackl JM (1989) Effect of prolonged sedation with propofol on erum triglyceride and cholesterol concentrations. Br J Anaesth 62: (1989) 393–384PubMedCrossRefGoogle Scholar
  24. 24.
    Gottardis M, Schlager A, Benzer A, Hackl JM, Furtwängler W, Schmutzhard E (1991) Die „Spectral Edge Frequency“. Anästhesiol Intensivmed 32: 142–145Google Scholar
  25. 25.
    Hudson RJ (1990) Apnoea and unconsciousness after apparent recovery from alfentanil- supplemented anaesthesia. Can J Anaesth 37: 255–257PubMedCrossRefGoogle Scholar
  26. 26.
    Hug CC (1985) Lipid solubility, pharmacokinetics, and the EEG: are You better off today than you were four years ago? Anesthesiology 62: 221–226PubMedCrossRefGoogle Scholar
  27. 27.
    Hug CC (1991) Opioids Pharmacokinetics and anesthetic effects. In: ASA (ed) 1991 Annual refresher course lectures. American Society of Anesthesiologists, San FranciscoGoogle Scholar
  28. 28.
    Hull CJ (1991) Drug distribution. In: Pharmacokinetics for anaesthesia. Butterworth & Heinemann, OxfordGoogle Scholar
  29. 29.
    Iberti TJ et al. (1990) Multicenter study of physician knowledge of the pulmonary artery catheter. JAMA 264: 2928–2932PubMedCrossRefGoogle Scholar
  30. 30.
    Jensen MP, Karoly P, Braver S (1986) The measurement of clinical pain intensity: a comparison of six methods. Pain 27: 117–126PubMedCrossRefGoogle Scholar
  31. 31.
    Jensen MP, Karoly P, O’Riordan EF, Bland F, Burns RS (1989) The subjective experience of acute pain. An assessment of the utility of 10 indices. Clin J Pain 5: 153–159PubMedCrossRefGoogle Scholar
  32. 32.
    Kaiko RF, Foley KM, Grabinski PY, Heidrich G, Rogers AG, Inturrisi CE, Reidenberg MM (1983) central nervous system excitatory effects or meperidine in cancer patients. Ann Neurol 13: 180–185Google Scholar
  33. 33.
    Kamp H-D (1990) Atemdepression nach verschiedenen Methoden der NLA. In: Henschel W (Hrsg) Neuroleptanalgesie. Urban & Schwarzenberg, MünchenGoogle Scholar
  34. 34.
    Kaufmann RD, Agleh KA, Belville JW (1979) Relative potencies and duration of action with respect to respiratory depression of intravenous meperidine, fentanyl and alphapro- dine in man. J Pharmacol Exp Ther 208: 73–79Google Scholar
  35. 35.
    Kelleher JF (1989) Pulse oximetry. J Clin Monit 5: 37–62CrossRefGoogle Scholar
  36. 36.
    Kochs E, Schulte am Esch J (1984) Hormone des Hypophysen-Nebennierensystems bei Patienten unter Langzeitsedierung mit Etomidate und Fentanyl. Anästhesist 33: 402–407Google Scholar
  37. 37.
    Kochs E, Schulte am Esch J (1988) Neurophysiologisches Monitoring (Elektroenzephalogramm evozierte Potentiale) und Benzodiazepinwirkung. Anästh Intensivther Notfallmed 23: 145–152PubMedCrossRefGoogle Scholar
  38. 38.
    Kochs E, Bischoff P, Rust U, Schulte am Esch J (1988) Beeinflussung des Hypophysen- Nebennierenrinden-Systems durch Langzeitanalgosedierung. In: Schulte am Esch J, Benzer H (Hrsg) Analgosedierung des Intensivpatienten. Springer, Berlin Heidelberg New YorkGoogle Scholar
  39. 39.
    Krane BD, Kreutz JM, Johnson DL, Mazuzan JE (1990) Alfentanil and delayed respiratory depression: Case studies and review. Anesth Analg 70: 557–561PubMedCrossRefGoogle Scholar
  40. 40.
    Krüger J, Steudel WI (1983) Korrelation zwischen EEG (FFT) und Bewußtseinsgrad bei Patienten in der frühen posttraumatischen Phase. EEG EMG 24: 115–168Google Scholar
  41. 41.
    Ledingham IM, Watt I (1984) Influence of sedation on mortality in critically ill multiple trauma patients. Lancet I: 1270Google Scholar
  42. 42.
    Ledingham IM, Finlay WEI, Watt I et al. (1983) Etomidate and adrenocortical function. Lancet I: 1434Google Scholar
  43. 43.
    Lehmann KA (1986) Pharmakokinetik: gibt es analgetische Blutkonzentrationen? In: Kettler D, Crozier T, Metzler H (Hrsg) Urban & Schwarzenberg, MünchenGoogle Scholar
  44. 44.
    Lehmann KA (1988) Analgosedierung mit Opioiden. In: Schulte am Esch J, Benzer H (Hrsg) Analgosedierung des Intensivpatienten. Springer, Berlin Heidelberg New YorkGoogle Scholar
  45. 45.
    Lehmann KA (Hrsg) (1990) Schmerzmessung und -dokumentation. In: Der postoperative Schmerz. Springer, Berlin Heidelberg New YorkGoogle Scholar
  46. 46.
    Lenhart F-P, Frey L,Wilm V,Taeger K (1988) Sedierung langzeitbeatmeter Patienten mit Methohexital und Opioiden. In: Link J, Eyrich K (Hrsg) Analgesie und Sedierung in der Intensivmedizin. Springer, Berlin Heidelberg New YorkGoogle Scholar
  47. 47.
    Ling GSF, Spiegel K, Nishimura SL, Pasternak GW (1983) Dissociation of morphine’s analgesic and respiratory depressant actions. Eur J Pharmacol 86: 487–488PubMedCrossRefGoogle Scholar
  48. 48.
    Link J, Papadopoulos G, Striebel HW, Heinemeyer G, Rohling R (1988) Analgesie und Sedierung während Intensivtherapie - Strategie und Taktik. In: Link J, Eyrich K (Hrsg) Springer, Berlin Heidelberg New YorkGoogle Scholar
  49. 49.
    Litscher G, Pfurtscheller G, Schwarz G, List W (1987) Akustisch evozierte Hirnstammpotentiale. Anaesthesist 36: 555–560PubMedGoogle Scholar
  50. 50.
    Mahla ME,White SE, Moneta MD (1988) Delayed respiratory depression after alfentanil. Anesthesiology 69: 593–595CrossRefGoogle Scholar
  51. 51.
    Mann HJ, Fuhs DW, Cerra FB (1987) Pharmacokinetics and pharmacodynamics in critically ill patients. World J Surg 11: 210–217PubMedCrossRefGoogle Scholar
  52. 52.
    Mapleson WW (1973) Br J Anaesth 45: 319–334PubMedCrossRefGoogle Scholar
  53. 53.
    Marks RM, Sachar E J (1973) Undertreatment of medical inpatients with narcotic analgesics. Ann Int Med 78: 173–181PubMedGoogle Scholar
  54. 54.
    McGillard KL, Takemori AE (1978) Antagonism by naloxone of narcotic-induced respiratory depression and analgesia. J Pharmacol Exp Ther 207: 494–503Google Scholar
  55. 55.
    Meldrum BS, Brierley JB (1969) Brain damage in the rhesus monkey resulting from profound arterial hypotension. II. Changes in spontaneous and evoked electrical activity of the neocortex. Brain Res 13: 101–118PubMedCrossRefGoogle Scholar
  56. 56.
    Mertes N, Thülig B, Zander J, Schöppner H (1989) Long-term sedation with continuous infusion of propofol in ventilated intensive care patients: preliminary experiences over 120 hours in six patients. J Drug Dev 2: 77–78Google Scholar
  57. 57.
    Oldenhof H, de Jong M, Steenhoek A, Janknegt R (1988) Clinical pharmacokinetics of midazolam in intensive care patients, a wide interpatients variability? Clin Pharmacol Ther 43: 263–269Google Scholar
  58. 58.
    O’ullivan GF, Park GR (1990) The assessment of sedation in critically ill patients. Clin Int Care 1: 116–122Google Scholar
  59. 59.
    Paloheimo M (1990) Quantitative surface electromyography applications in anesthesiology and critical care. Acta Anaesthesiol Scand 34: 1–83CrossRefGoogle Scholar
  60. 60.
    Papadopoulos G, Striebel HW, Heinemeyer G, Link J (1988) Sedierung mit Diazepam bei langzeitbeatmeten Patienten unter Basisanalgesie mit Neuroleptanalgesie: Pharmakokinetik - Pharmakodynamik. In: Link J, Eyrich K (Hrsg) Analgesie und Sedierung in der Intensivmedizin. Springer, Berlin Heidelberg New YorkGoogle Scholar
  61. 61.
    Penfold NW, Park GR (1990) Effects of organ failure and therapy on drug metabolism. Curr Op Anaesth 3: 235–240CrossRefGoogle Scholar
  62. 62.
    Rampil IJ, Sasse FJ, Smith NT, Hoff BH, Flemming DC (1980) Spectral edge frequency - a new correlate of anesthetic depth. Anesthesiology 53: 512CrossRefGoogle Scholar
  63. 63.
    Riffel B, Sommer-Edlinger B, Kroiss H (1991) Somatosensorisch evozierte Potentiale (SEP). In: Stöhr M, RiffelB, Pfadenhauer K (Hrsg) Neuro-physiologischeUntersuchungsmethoden in der Intensivmedizin. Springer, Berlin Heidelberg New YorkGoogle Scholar
  64. 64.
    Rohling R, Papadopoulos G, Striebel HW, Link J, Heinemeyer G (1988) Basisanalgose- dierung mit Fentanyl und Dehydrobenzperidol bei beatmeten Intensivpatienten. In: Link J, Eyrich K (Hrsg) Springer, Berlin Heidelberg New YorkGoogle Scholar
  65. 65.
    Russell IF (1989) Conscious awareness during general anaesthesia: relevance of autonomic signs and isolated arm movements as guides to depth of anaesthesia. In: Jones JG (ed) BailliÀre’s clinical anaesthesiology. BailliÀre-Tindall, LondonGoogle Scholar
  66. 66.
    Schwarz G, Pfurtscheller G, List W (1986) Akustisch evozierte Hirnstammpotentiale - Möglichkeiten und Probleme auf der Intensivstation. Anästh Intens Notfallmed 21: 262CrossRefGoogle Scholar
  67. 67.
    Schwilden H (1988) Sedierung und EEG bei Intensivpatienten. In: Link J, Eyrich K (Hrsg) Analgesie und Sedierung in der Intensivmedizin. Springer, Berlin Heidelberg New YorkGoogle Scholar
  68. 68.
    Schwilden H, Stoeckel H (1987) The unprocessed EED. In: Rosen M, Nunn JN (eds) Consciousness, awareness and pain in general anaesthesia. Butterworths, LondonGoogle Scholar
  69. 69.
    Sear JW, Fisher A, Summerfield RJ (1987) Is alfentanil by infusion useful for sedation on ITU? Eur J Anaesth Suppl 1: 55–61Google Scholar
  70. 70.
    Severinghaus JW (1982) Transcutaneous gas analysis. Respir Care 27: 152Google Scholar
  71. 71.
    Severinghaus JW (1991) Oximetry: what does it tell you? In: ASA (ed) 1991 Annual refresher course lectures. San FranciscoGoogle Scholar
  72. 72.
    Sinclair ME, Suter PM (1988) Detection of overdosage of sedation in a patient with renal failure by the absence of lower oesophageal motility. Intens Care Med 14: 69–71CrossRefGoogle Scholar
  73. 73.
    Steward DJ (1975) A simplified scoring system for the post-operative recovery room. Can Anesth Soc J 22: 111CrossRefGoogle Scholar
  74. 74.
    Stoeckel H, Hengstmann JH, J Schüttler (1979) Pharmacokinetics of fentanyl as a possible explanation for recurrence of respiratory depression. Br J Anaesth 51: 741PubMedCrossRefGoogle Scholar
  75. 75.
    Stoeckel H, Schwilden H (1987) Median EEG frequency. In: Rosen M, Lunn JN (eds) Consciousness, awareness and pain in general anaesthesia. Butterworths, LondonGoogle Scholar
  76. 76.
    Stöhr M, Riffel B, Pfadenhauer K (1991) Neurophysiologische Untersuchungsmethoden in der Intensivmedizin. Springer, Berlin Heidelberg New YorkGoogle Scholar
  77. 77.
    Thornton C, Konieczko K, Jones JG et al. (1988) Effect of surgical stimulation on the auditory evoked response. Br J Anaesth 60: 372–378PubMedCrossRefGoogle Scholar
  78. 78.
    Tremper KK, Barker SJ (1989) Pulse oximetry. Anesthesiology 70: 98–108Google Scholar
  79. 79.
    Tremper KK, William MD, Shoemaker C (1981) Transcutaneous osygen monitoring of critically ill adults with and without low flow shock. Crit Care Med 9: 706PubMedCrossRefGoogle Scholar
  80. 80.
    Velasco M,Velasco F, Castaneda R et al. (1984) Effect of fentanyl and naloxone on human somatic and auditory evoked potential components. Neuropharmacology 23: 359–366Google Scholar
  81. 81.
    Veselis RA, Reinsei R, Sommer S, Carlon G (1991) Use of neural network analysis to classify electroencephalographic patterns against depth of midazolam sedation in intensive care unit patients. J Clin Monit 7: 259–267PubMedCrossRefGoogle Scholar
  82. 82.
    White PF (1991) Patient-controlled analgesia: The use of on-demand opioids in the management of acute pain. In: Estafanous FG (ed) Opioids in anesthesia I I. Butterworth & Heinemann, BostonGoogle Scholar
  83. 83.
    Wukitsch MW, Petterson MT,Tobler DR, Pologe JA (1988) Pulse oximetry: Analysis of theory, technology and practice. J Clin Monit 4: 290–301Google Scholar
  84. 84.
    Yelderman M, New W (1983) Evaluation of pulse oximetry. Anesthesiology 59: 349PubMedCrossRefGoogle Scholar
  85. 85.
    Zegers de Beyl D, Mavroudakis N, Brunko E (1989) Monitoring brain failure using evoked potentials. In: Bihari D, Holaday JW (eds) Brain failure. Springer, Berlin Heidelberg New YorkGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • J. Zander

There are no affiliations available

Personalised recommendations