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Die Anästhesiologie pp 1–14Cite as

Anästhesie bei Patienten mit Suchterkrankungen

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Part of the book series: Springer Reference Medizin ((SRM))

Zusammenfassung

Im operativ-chirurgischen Bereich besteht eine hohe Prävalenz von Suchterkrankungen. Substanzmissbrauch ist mit einer erhöhten Morbidität assoziiert. Dies bedingt einen häufigen Kontakt des klinisch tätigen Anästhesisten mit suchtkranken Patienten. Beim suchtkranken Patienten ist ein gezieltes diagnostisches Vorgehen erforderlich, da die Suchtdiagnose oft entweder erst anhand von Komplikationen im Verlauf gestellt wird oder die Intoxikation eine schwerwiegende Erkrankung verschleiert (z. B. Schädel-Hirn-Trauma und Alkoholintoxikation, Delir und Thiaminmangel, myokardiale Ischämie und Kokainabusus, Schmerzsyndrome und Opiatabusus). Viele Patienten nehmen mehr als eine Substanz ein (u. a. als Selbstmedikation bei Entzug oder psychiatrischen Erkrankungen). Die wichtigsten Aspekte werden in diesem Kapitel dargestellt.

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Literatur

  1. AWMF S3 – Leitlinie AWMF Leitlinien-Registernummer 076-001: Screening, Diagnose und Behandlung alkoholbezogener Störungen (Im Druck 2015). www.AWMF.org

  2. AWMF S3 – Leitlinie AWMF Leitlinien-Registernummer 076-006: Interdisziplinäre Leitlinie der Qualität S3 zum Screening, der Diagnostik und Behandlung des schädlichen und abhängigen Tabakkonsums (Im Druck 2015). www.AWMF.org

  3. Awissi DK, Lebrun G, Fagnan M, Skrobik Y, Regroupement de Soins Critiques, Réseau de Soins Respiratoires, Québec (2013) Alcohol, nicotine, and iatrogenic withdrawals in the ICU. Crit Care Med 41(9 Suppl 1):S57–S68, Review

    Article  CAS  PubMed  Google Scholar 

  4. Bell J, Reed K, Gross S, Mr John Witton J (2013) The management of pain in people with a past or current history of addiction. www.actiononaddiction.org.uk

  5. Courtney KE, Ray LA (2014) Methamphetamine: an update on epidemiology, pharmacology, clinical phenomenology, and treatment literature. Drug Alcohol Depend 143:11–21

    Article  CAS  PubMed  Google Scholar 

  6. DG Suchtmedizin (2014). http://www.dgsuchtmedizin.de/fileadmin/documents/Leitlinien/Leitlinien_Substitution_der_DGS-29-01-2014.pdf. Zugegriffen am 22.11.2014

  7. Egred M, Davis GK (2005) Cocaine and the heart. Postgrad Med J 81:568–571

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Sander M, Neumann T, von Dossow V et al (2006) Alkoholabusus: Risikofaktoren für die Anästhesie und Intensivmedizin (Alcohol use disorder: risks in anesthesia and intensive care medicine). Internist 47:332–341

    Article  CAS  PubMed  Google Scholar 

  9. Spies CD, Rommelspacher H (1999) Alcohol withdrawal in the surgical patient: prevention and treatment. Anesth Analg 88:946–952

    Article  CAS  PubMed  Google Scholar 

  10. Thomson AD, Guerrini I, Marshall EJ (2012) The evolution and treatment of Korsakoff’s syndrome: out of sight, out of mind? Neuropsychol Rev 22(2):81–92. https://doi.org/10.1007/s11065-012-9196-z, Epub 2012 May 9 Review

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Kip M, Neumann T, Jugel C et al (2008) New strategies to detect alcohol use disorder in the preoperative assessment clinic of a German university hospital. Anesthesiology 109:169–170

    Article  Google Scholar 

  12. Galvin R, Bråthen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA, EFNS (2010) FNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol 2010(17):1408–1418

    Article  Google Scholar 

  13. Lieber CS (1995) Medical disorders of alcoholism. N Engl J Med 333:1058–1065

    Article  CAS  PubMed  Google Scholar 

  14. Neumann T, Kox WJ, Spies CD (2003) Anästhesiologisches Vorgehen bei Sucht- und Begleiterkrankungen in Forschung und Praxis. Suchtmed 5:13–20

    Google Scholar 

  15. Neumann T, Spies C (2003) Use of biochemical markers in clinical practice. Addiction 98(Suppl 2):81–91

    Article  PubMed  Google Scholar 

  16. Spies CD, Nordmann A, Brummer G et al (1996) Intensive care unit stay is prolonged in chronic alcoholic men following tumor resection of the upper digestive tract. Acta Anaesthesiol Scand 40:649–656

    Article  CAS  PubMed  Google Scholar 

  17. Tønnesen H, Kehlet H (1999) Preoperative alcoholism and postoperative morbidity. Br J Surg 86:869–874

    Article  PubMed  Google Scholar 

  18. Neumann T, Neuner B, Weiss-Gerlach E et al (2006) The effect of computerized tailored brief advice on at-risk drinking in subcritically injured trauma patients. J Trauma 61:805–814 #22

    Article  PubMed  Google Scholar 

  19. Klotz U, Ammon E (1998) Clinical and toxicological consequences of the inductive potential of ethanol. Eur J Clin Pharmacol 54:7–12

    Article  CAS  PubMed  Google Scholar 

  20. Riordan SM, Williams R (2002) Alcohol exposure and paracetamol-induced hepatotoxicity. Addict Biol 7:191–206

    Article  CAS  PubMed  Google Scholar 

  21. Nuscheler M, Conzen P, Peter K (1989) Sevofluran. Metabolismus und Toxizität. Anästhesist 47:S24–S32

    Article  Google Scholar 

  22. Kork F, Neumann T, Spies C (2010) Perioperative management of patients with alcohol, tobacco and drug dependency. Curr Opin Anaesthesiol 23(3):384–390

    Article  PubMed  Google Scholar 

  23. Tønnesen H, Nielsen PR, Lauritzen JB et al (2009) Smoking and alcohol intervention before surgery: evidence for best practice. Br J Anesth 102:297–306

    Article  Google Scholar 

  24. Trzepacz PT, Brenner RP, Coffman GC et al (1988) Delirium in liver-transplantation candidates: discriminant analysis of multiple test variables. Biol Psychiatry 24:3–15

    Article  CAS  PubMed  Google Scholar 

  25. Neumann T, Neuner B, Gentilello LM et al (2004) Gender differences in the performance of a computerized version of the alcohol use disorders identification test in subcritically injured patients who are admitted to the emergency department. Alcohol Clin Exp Res 28:1693–16701

    Article  PubMed  Google Scholar 

  26. Rumpf HJ, Meyer C, Hapke U, John U (2003) Deutsche Version des Alcohol Use Disorders Identification Test (AUDIT-G-L). In: Glöckner-Rist A, Rist F, Küfner H (Hrsg) Elektronisches Handbuch zu Erhebungsinstrumenten im Suchtbereich (EHES). Version 3.00. Zentrum für Umfragen, Methoden und Analysen, Mannheim

    Google Scholar 

  27. Martin MJ, Heymann C, Neumann T et al (2002) Preoperative evaluation of chronic alcoholics assessed for surgery of the upper digestive tract. Alcohol Clin Exp Res 26:836–840

    Article  CAS  PubMed  Google Scholar 

  28. Tønnesen H, Rosenberg J, Nielsen HJ et al (1999) Effect of preoperative abstinence on poor postoperative outcome in alcohol misusers: randomised controlled trial. BMJ 318:1311–1316

    Article  PubMed  PubMed Central  Google Scholar 

  29. Spies C, Eggers V, Szabo G et al (2006) Intervention at the level of the neuroendocrine-immune axis and postoperative pneumonia rate in long-term alcoholics. Am J Respir Crit Care Med 174:408–414

    Article  CAS  PubMed  Google Scholar 

  30. Ungur LA, Neuner B, John S, Wernecke K, Spies C (2013) Prevention and therapy of alcohol withdrawal on intensive care units: systematic review of controlled trials. Alcohol Clin Exp Res 37:675–686

    Article  CAS  PubMed  Google Scholar 

  31. Lingford-Hughes AR, Welch S, Peters L, Nutt DJ, British Association for Psychopharmacology, Expert Reviewers Group (2012) BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP. J Psychopharmacol 26:899–952

    Article  CAS  PubMed  Google Scholar 

  32. Garfield JM, Bukusoglu C (1996) Propofol and ethanol produce additive hypnotic and anesthetic effects in the mouse. Anesth Analg 83:156–161

    Article  CAS  PubMed  Google Scholar 

  33. Spies CD, Otter HE, Hüske B, Sinha P, Neumann T, Rettig J, Lenzenhuber E, Kox WJ, Sellers EM (2003) Alcohol withdrawal severity is decreased by symptom-orientated adjusted bolus therapy in the ICU. Intensive Care Med 29:2230–2238

    Article  PubMed  Google Scholar 

  34. Sullivan JT, Sykora K, Schneidermann J, Naranjo CA, Sellers EM (1989) Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict 84:1353–1357

    Article  CAS  PubMed  Google Scholar 

  35. Otter H, Martin J, Bäsell K et al (2005) Validity and reliability of the DDS for severity of delirium in the ICU. Neurocrit Care 2:150–158

    Article  PubMed  Google Scholar 

  36. Martin J, Heymann A, Bäsell K et al (2010) Evidence and consensus-based German guidelines for the management of analgesia, sedation and delirium in intensive care – short version. Ger Med Sci 8:Doc02

    Google Scholar 

  37. Ely EW, Inouye SK, Bernard GR et al (2001) Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method forthe intensive care unit (CAM-ICU). JAMA 286:2703–2710

    Article  CAS  PubMed  Google Scholar 

  38. Lütz A, Heymann A, Radtke FM (2010) Different assessment tools for intensive care delirium: which score to use? Crit Care Med 38:409–418

    Article  Google Scholar 

  39. Mueller SW, Preslaski CR, Kiser TH, Fish DN, Lavelle JC, Malkoski SP, MacLaren R (2014) A randomized, double-blind, placebo-controlled dose range study of dexmedetomidine as adjunctive therapy for alcohol withdrawal. Crit Care Med 42(5):1131–1139

    Article  CAS  PubMed  Google Scholar 

  40. Wong A, Benedict NJ, Kane-Gill SL (2014) Multicenter evaluation of pharmacologic management and outcomes associated with severe resistant alcohol withdrawal. J Crit Care. https://doi.org/10.1016/j.jcrc.2014.10.008

    Article  PubMed  PubMed Central  Google Scholar 

  41. Hernandez M, Birnbach DJ, Van Zundert AA (2005) Anesthetic management of the illicit-substance-using patient. Curr Opin Anaesthesiol 18:315–324

    Article  PubMed  Google Scholar 

  42. Schlatter J, Madras JL, Saulnier JL, Poujade F (1999) Drug interactions with methadone. Presse Med 28:1381–1384

    PubMed  CAS  Google Scholar 

  43. Schmoldt A (2004) Arzneimittelinteraktionen bei substituierten Heroinabhängigen. Suchttherapie 5:162–166

    Article  Google Scholar 

  44. Kleinwächter R, Kork F, Weiß-Gerlach E et al (2010) Improving the detection of illicit substance use in preoperative anesthesiological assessment. Minerva Anesthesiol 76:29–37

    Google Scholar 

  45. Hoffman RS, Hollander JE (1997) Evaluation of patients with chest pain after cocain use. Crit Care Clin 13:809–828

    Article  CAS  PubMed  Google Scholar 

  46. Hollander JE, Henry TD (2006) Evaluation and management of the patient who has cocaine-associated chest pain. Cardiol Clin 24:103–114

    Article  PubMed  Google Scholar 

  47. Hyatt B, Bensky KP (1999) Illicit drugs and anesthesia. CRNA 10:15–23

    PubMed  CAS  Google Scholar 

  48. Lange RA, Hillis LD (2001) Cardiovascular complications of cocaine use. N Engl J Med 345:351–358

    Article  CAS  PubMed  Google Scholar 

  49. Steadman JL, Birnbach DJ (2003) Patients on party drugs undergoing anesthesia. Curr Opin Anaesthesiol 16:147–152

    Article  PubMed  Google Scholar 

  50. Greene SL, Kerr F, Braitberg G (2008) Review article: amphetamines and related drugs of abuse. Emerg Med Australas 20(5):391–402

    Article  PubMed  Google Scholar 

  51. Courtney KE, Ray LA (2014) Methamphetamine: an update on epidemiology, pharmacology, clinical phenomenology, and treatment literature. Drug Alcohol Depend 143:11–21

    Article  CAS  PubMed  Google Scholar 

  52. Hawley LA, Auten JD, Matteucci MJ, Decker L, Hurst N, Beer W, Clark RF (2013) Cardiac complications of adult methamphetamine exposures. J Emerg Med 45(6):821–827

    Article  PubMed  Google Scholar 

  53. Henry JA, Jeffreys KJ, Dawling S (1992) Toxicity and deaths from 3,4-methylenedioxymethamphetamine. Lancet 340:384–387

    Article  CAS  Google Scholar 

  54. Die Drogenbeauftragte der Bundesregierung, Bundesministerium für Gesundheit (BMG), Bundesärztekammer (BÄK) (2016) S3-Leitlinie Methamphetamin-bezogene Störungen, Konsultationsfassung. www.crystal-meth.aezq.de

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Author information

Authors and Affiliations

  1. Klinik für Anästhesiologie m.S. operative Intensivmedizin, Charité - Universitätsmedizin Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Deutschland

    Tim Neumann

  2. Klinik für Anästhesiologie m.S. operative Intensivmedizin, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin, Augustenburger Platz 1, 13353, Berlin, Deutschland

    Claudia Spies

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  1. Tim Neumann
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  2. Claudia Spies
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Correspondence to Tim Neumann .

Editor information

Editors and Affiliations

  1. Klinik für Anästhesiologie, Universitätsklinikum Aachen RWTH Aachen, Aachen, Germany

    Rolf Rossaint

  2. Universitätsklinikum Mainz Klinik für Anästhesiologie, Mainz, Germany

    Christian Werner

  3. Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum München Klinikum Großhadern, München, Germany

    Bernhard Zwißler

Section Editor information

  1. Klinikum der Universität München, Klinik für Anästhesiologie, Marchioninistr. 15, 81377, München, Germany

    Bernhard Zwißler

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Neumann, T., Spies, C. (2016). Anästhesie bei Patienten mit Suchterkrankungen. In: Rossaint, R., Werner, C., Zwißler, B. (eds) Die Anästhesiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45539-5_117-1

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  • DOI: https://doi.org/10.1007/978-3-662-45539-5_117-1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-45539-5

  • Online ISBN: 978-3-662-45539-5

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