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Spezielle Probleme der Anästhesie und der unmittelbaren postoperativen Versorgung

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Gynäkologische Operationen

Part of the book series: Kirschnersche allgemeine und spezielle Operationslehre ((OPERATIONSLEHRE,volume 9))

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Zusammenfassung

Die allgemein akzeptierten Forderungen an eine zufriedenstellende Anästhesie sind Schmerzausschaltung, Reflexunterdrückung und Relaxierung. Bei manchen Eingriffen mögen zudem Hypnose und Amnesie erwünscht sein. Das weitreichende Operationsfeld gynäkologischer Operationen, das die Dermatome von C 3 (Mamma) bis S 5 (Perineum) einschließt, sowie das sehr unterschiedlich zusammengesetzte Patientengut, das von gesunden Frauen (Tubensterilisation) bis zu moribunden Patientinnen (Tumorchirurgie) reicht, bedingt vielfältige medizinische Probleme bei der Anästhesievorbereitung und Durchführung. Der prä- und intraoperative Aufwand der angewandten Screening- und Überwachungsverfahren richtet sich sowohl nach der Größe des operativen Eingriffs als auch nach dem individuellen Gesundheitszustand der Patientin. Entsprechend den Empfehlungen der American Society of Anesthesiologists [79], werden 5 Risikogruppen unterschieden. Diese stellen einen brauchbaren Parameter für die zu erwartenden intra- und postoperativen Probleme dar [39] (Tabelle 1).

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  1. R. Deckardt
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  1. I. Frauenklinik der Universität, Maistraße 11, D-8000, München 2, Deutschland

    Josef Zander em. Prof. Dr. Dr. h. c. , R. Kürzl Priv.-Doz. Dr.  & B. Lampe Dr. ,  & 

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  13. Frauenklinik der Universität, Klinikum Großhadern, Marchioninistraße 15, D-8000, München 70, Deutschland

    H. Hepp Prof. Dr.  & M. Korell Dr.  & 

  14. Chirurgische Klinik und Poliklinik der Technischen Universität, Klinikum rechts der Isar, Ismaninger Straße 22, D-8000, München 80, Deutschland

    M. Hölscher Prof. Dr.  & J. R. Siewert Prof. Dr.  & 

  15. Frauenklinik, Klinikum Bamberg, Bugerstraße 80, D-8600, Bamberg, Deutschland

    R. von Hugo Prof. Dr.

  16. Zentrum Chirurgie, Klinik für Urologie, Medizinische Hochschule Hannover, Konstanty-Gutschow-Straße 8, D-3000, Hannover 61, Deutschland

    U. Jonas Prof. Dr.

  17. Martin-Luther-Krankenhaus, Caspar-Theyss-Straße 27/29, D-1000, Berlin 33, Deutschland

    E. Kastendieck E., Prof. Dr.

  18. Universitäts-Frauenklinik, Langenbeckstraße 1, D-6500, Mainz, Deutschland

    P. G. Knapstein Prof. Dr.  & M. Mahlke Dr.  & 

  19. Friedrichstraße 1, D-8000, München 40, Deutschland

    P. Krieglsteiner Prof. Dr.

  20. Frauenklinik und Hebammenlehranstalt der Universität, Robert-Koch-Straße 40, D-3400, Göttingen, Deutschland

    W. Kuhn Prof. Dr.

  21. Michaelis-Krankenhaus e. V., Am Weiher 7, D-2000, Hamburg 20, Deutschland

    H.-J. Lindemann Prof. Dr.

  22. Gynäkologisch-geburtshilfliche Abteilung, Städtischen Krankenhaus München-Schwabing, Kölner Platz 1, D-8000, München 40, Deutschland

    K. J. Lohe Prof. Dr.

  23. Alexander-von-Humboldt-Straße 8, D-6120, Erbach/Odenwald, Deutschland

    R. T. Michel Priv.-Doz. Dr.

  24. Institut für Rechtsmedizin der Universität, Frauenlobstraße 7a, D-8000, München 2, Deutschland

    R. Penning Dr.  & W. Spann em. Prof. Dr. Dr. h. c.  & 

  25. Frauenklinik, Evangelisches Krankenhaus Oberhausen, Virchowstraße 20, D-4200, Oberhausen 1, Deutschland

    P. Quent Dr.

  26. Frauenklinik und Hebammenlehranstalt der Universität, Robert-Koch-Straße 40, D-3400, Göttingen, Deutschland

    W. Rath Priv.-Doz. Dr.

  27. Radiologische Klinik der Universität, Sigmund-Freud-Straße 25, D-5300, Bonn 1, Deutschland

    M. Reiser Prof. Dr.

  28. Institut für Anästhesiologie der Technischen Universität, Klinikum rechts der Isar, Ismaninger Straße 22, D-8000, München 80, Deutschland

    M. Rust Priv.-Doz. Dr.

  29. Abteilung für Gynäkologie und Geburtshilfe, Marienkrankenhaus, Alfredstraße 9, D-2000, Hamburg 76, Deutschland

    P. Scheidel Prof. Dr.

  30. Humperdinckstraße 11, D-6000, Frankfurt/Main 70, Deutschland

    H. Schmidt-Matthiesen em. Prof. Dr.

  31. Institut für Medizinische Statistik und Epidemiologie der Technischen Universität, Klinikum rechts der Isar, Ismaninger Straße 22, D-8000, München 80, Deutschland

    J. Schöffel Dr.  & R. Thurmayr Prof. Dr.  & 

  32. FRCOG, Frauenklinik der Universität und Michaelis-Hebammenschule, Michaelisstraße 16, D-2300, Kiel 1, Deutschland

    K. Semm Prof. Dr. Dr. h. c.

  33. School of Medicine, Division of Gynecologic Oncology (D-52), Department of Obstetrics and Gynecology, University of Miami, P. O. Box 016960, 33101, Miami, FL, USA

    B.-U. Sevin Prof. Dr.

  34. Städtisches Krankenhaus Merheim, Ostmerheimer Straße 200, D-5000, Köln 91, Deutschland

    G. Spilker Prof. Dr. Dr.

  35. Frauenklinik, Klinikum Landshut, Robert-Koch-Straße 1, D-8300, Landshut, Deutschland

    R. Strigl Prof. Dr.

  36. I. Medizinische Klinik und Poliklinik der Technischen Universität, Klinikum rechts der Isar, Ismaninger Straße 22, D-8000, München 80, Deutschland

    W. Theiss Prof. Dr.

  37. Kreiskrankenhaus Ellwangen, Dalkinger Straße 8-12, D-7090, Ellwangen, Deutschland

    B. Ultsch Prof. Dr.

  38. Gemeinschaftspraxis, Ernst-Reuter-Platz 2, D-8060, Dachau, Deutschland

    J. de Waal Dr.

  39. Universitäts-Frauenklinik und Hebammenschule, Josef-Schneider-Straße 4, D-8700, Würzburg, Deutschland

    K.-H. Wulf Prof. Dr.

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Deckardt, R., Rust, M. (1991). Spezielle Probleme der Anästhesie und der unmittelbaren postoperativen Versorgung. In: Zander, J., et al. Gynäkologische Operationen. Kirschnersche allgemeine und spezielle Operationslehre, vol 9. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-95540-2_10

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  • DOI: https://doi.org/10.1007/978-3-642-95540-2_10

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