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Gender-Aspekte in der Anästhesie

Modifiziertes Vorgehen in Forschung und Versorgung?

Gender aspects in anesthesia

Modified approach in research and treatment?

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Zusammenfassung

Geschlechtsspezifische Unterschiede können einen relevanten Einfluss auf den perioperativen Verlauf haben. Männliche und weibliche Patienten sind unterschiedlich häufig und schwer von unerwünschten Ereignissen, z. B. Medikamentennebenwirkungen, betroffen. Außerdem wurden Unterschiede bei der Medikamentenwirkung, bei anästhesierelevanten Vorerkrankungen und beim „outcome“ nach Narkosen und intensivmedizinischen Krankheitsbildern beschrieben. Bei Diagnostik und Therapie scheint ein „gender bias“ zu existieren. Obwohl das Wissen darüber längst nicht vollständig ist, wurde die Kenntnis um diese Unterschiede in Ansätzen bereits in die klinische Praxis integriert [Prophylaxe von „postoperative nausea and vomiting“ (PONV), „Target-controlled-infusion“(TCI)-Modell, „male only policy“ bei Plasmaprodukten]. In Zeiten individualisierter Medizin ist es sinnvoll, den Einfluss des Patientengeschlechts ebenso wie den des Patientenalters und der- ethnie weiterzuuntersuchen. In diesem Beitrag werden die bisher bekannten Unterschiede vorgestellt und mögliche Ursachen diskutiert.

Abstract

Gender differences can have a relevant influence on the perioperative outcome as male and female patients are affected differently by adverse events, e.g. side effects of drugs. Furthermore, differences relating to specific drug effects, comorbidities and outcome after anesthesia or intensive care have been demonstrated. There seems to be a gender bias in diagnosis and therapy. While the knowledge regarding this field is still growing certain aspects have already been integrated into clinical practice: prevention of postoperative nausea and vomiting (PONV), target controlled infusion (TCI) model and male only policy with production of blood products. There is a need to study the influence of gender, age and race in order to optimize treatment towards a more individualized therapy. This article highlights already identified differences and discusses potential underlying mechanisms.

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  1. Klinik für Anästhesiologie, Klinikum der Universität München, Campus Innenstadt, Nussbaumstr. 20, 80336, München, Deutschland

    M. Schopper, P.I. Bäumler, J. Fleckenstein & D. Irnich

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  1. M. Schopper
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  2. P.I. Bäumler
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  3. J. Fleckenstein
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Schopper, M., Bäumler, P., Fleckenstein, J. et al. Gender-Aspekte in der Anästhesie. Anaesthesist 61, 288–298 (2012). https://doi.org/10.1007/s00101-012-2013-5

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