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Komplikationen bei peripherer Regionalanästhesie

Complications of peripheral regional anesthesia

  • Regionalanästhesie
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Zusammenfassung

Die periphere Regionalanästhesie ist ein sicheres Anästhesieverfahren. Allgemeine Komplikationen sind selten. Schwere Nervenschäden treten je nach Definition mit einer Inzidenz <0,1% auf und haben oft eine gute Prognose. Zur Vermeidung von Blutungskomplikationen gibt es nationale Richtlinien zur Durchführung unter laufender Antikoagulation, die beachtet werden müssen. Intoxikationen treten v. a. bei versehentlicher intravasaler Gabe auf und sind teilweise schwer therapierbar; die Gabe von Fettlösung kann die Reanimierbarkeit der Patienten verbessern. Infektionen können v. a. bei Katheterverfahren auftreten und bedingen ein streng aseptisches Vorgehen bei der Anlage. Seltene Komplikationen sind Allergien, Dislokationen sowie Katheterabrisse oder Schlingenbildungen. Neben den allgemeinen Komplikationen gibt es verfahrenstypische Komplikationen wie z. B. einen Pneumothorax oder Nierenpunktionen, die einer besonderer Beachtung bedürfen.

Abstract

Peripheral regional anesthesia is a commonly used and safe procedure and eneral complications or side effects are generally rare. Nerve damage has an incidence <0.1% depending on the definition and the prognosis is good. To avoid bleeding complications the national standards of block performance under antithrombotic therapy should be respected. Intoxication is mainly the result of accidental intravenous administration and is difficult to treat but higher doses of intravenous lipid emulsions can improve the outcome. Potential infectious complications can occur mainly as a result of catheter techniques and require a strict aseptic approach. Further rare complications are allergies, dislocation of catheters and knotting or loops in catheters. Besides the general complications, there are some specific complications depending on the puncture site, such as pneumothorax or renal puncture.

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Der korrespondierende Autor weist auf folgende Beziehungen hin: Beide Autoren: gelegentlich Vortragstätigkeiten für die Fa. AstraZeneca.

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  1. Abteilung für Anästhesie und Intensivmedizin, Ortenau Klinikum, Josef-Wurzler-Str. 7, 77855, Achern, Deutschland

    M. Neuburger

  2. Abteilung für Anästhesie, BG Unfallklinik, Murnau, Deutschland

    J. Büttner

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Neuburger, M., Büttner, J. Komplikationen bei peripherer Regionalanästhesie. Anaesthesist 60, 1014–1026 (2011). https://doi.org/10.1007/s00101-011-1955-3

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