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Schmerztherapie bei Schwangeren

  • Chapter
Der postoperative Schmerz
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Zusammenfassung

Für den Einsatz von Analgetika in der Schwangerschaft sollten folgende Gesichtspunkte besonders berücksichtigt werden:

  • Auswirkung auf das ungeborene Leben in Abhängigkeit vom Stadium der Schwangerschaft,

  • Einfluß auf die Mutter und den Schwangerschaftsverlauf,

  • Analgesie und Gestose,

  • Analgesie bei stillenden Müttern.

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Literatur

  1. Abboud TK, Khoo SS, Miller F, Doan T, Henriksen EH (1982) Maternal, fetal, and neonatal responses after epidural anesthesia with bupivacaine, 2-chloroprocaine, or lidocaine. Anesth Analg 61:638–644

    Article  PubMed  CAS  Google Scholar 

  2. Abboud TK, Kim KC, Noueihed R, Kuhnert BR, Der Mardirossian N, Moumdjian J, Sarkis F, Nagappala S (1983) Epidural bupivacaine, chloroprocaine, or lidocaine for cesarean section — maternal and neonatal effects. Anesth Analg 62:914–919

    PubMed  CAS  Google Scholar 

  3. American Academy of Pediatrics. Committee on Drugs (1989) Transfer of drugs and other chemicals into human milk. Pediatrics 84:924–936

    Google Scholar 

  4. Amon I, Zschiesche A, Amon K (1983) Verteilung von Salizylsäure und Hydrolyse der Azetylsalizylsäure bei menschlichen Feten in der Frühschwangerschaft. Biomed Biochim Acta 42:997–1004

    PubMed  CAS  Google Scholar 

  5. Anderson PO (1991) Drug use during breast-feeding. Clin Pharm 10:594–624

    PubMed  CAS  Google Scholar 

  6. Ansell C, Moore A, Barrie H (1977) Electrolyte and pH changes in human milk. Pediatr Res 11:1177–1179

    Article  PubMed  CAS  Google Scholar 

  7. Aterman K, Holzbecher M, Ellenberger HA (1980) Salicylate levels in a stillborn infant born to a drug-addicted mother, with comments on pathology and analytical methodology. Clin Toxicol 16:263–268

    Article  PubMed  CAS  Google Scholar 

  8. Atkinson HC, Begg EJ, Darlow BA (1988) Drugs in human milk: clinical pharmocokinetic considerations. Clin Pharmacokinet 14:217–240

    Article  PubMed  CAS  Google Scholar 

  9. Baker PA, Schroeder D (1989) Interpleural bupivacaine for postoperative pain during lactation. Anesth Analg 69:400–402

    Article  PubMed  CAS  Google Scholar 

  10. Beaufils M, Uzan S, Donsimoni R, Colau JC (1984) Essai contrôle d’un traitement préventif de la prééclampsie. Résultats préliminaires. Arch Mal Coeur 77:1226–1228

    PubMed  CAS  Google Scholar 

  11. Bennett P, Matheson I, Dukes MNG, Notarianni IJ, Orme MLE, Rane A, Reinhardt D, Soderman P, Wilson JT (eds) (1988) Drugs and human lactation. Elsevier, Amsterdam

    Google Scholar 

  12. Berlin CM, Pascuzzi MJ, Yaffe SJ (1980) Excretion of salicylate in human milk. Clin Pharmacol Ther 27:245–246

    Google Scholar 

  13. Besunder JB, Reed MD, Bulmer JL (1988) Principles of drug biodisposition in the neonate. A critical evaluation of the pharmacokinetic-pharmacodynamic interface (part 1). Clin Pharmacokinet 14:189–216

    Article  PubMed  CAS  Google Scholar 

  14. Bitzen PO, Gustafsson B, Jostell KG, Melander A, Wahlin-Boll E (1981) Excretion of paracetamol in human breast milk. Eur J Clin Pharmacol 20:123–125

    Article  PubMed  CAS  Google Scholar 

  15. Bovill JG, Sebel PS, Blackburn CL, Oei-Lim V, Heykants JJ (1984) The pharmacokinetics of sufentanil in surgical patients. Anesthesiology 61:502–506

    Article  PubMed  CAS  Google Scholar 

  16. Bower S, Hull CJ (1982) Comparative pharmacokinetics of fentanyl and alfentanil. Br J Anaesth 54:871–877

    Article  PubMed  CAS  Google Scholar 

  17. Brash AR, Hickey DE, Graham TP, Stahlman MT, Oates JA, Cotton RB (1981) Pharmacokinetics of indomethacin in the neonate. Relation of plasma indomethacin levels to response of the ductus arteriosus. N Engl J Med 305:67–72

    Article  PubMed  CAS  Google Scholar 

  18. Cantor B, Tyler T, Nelson RM, Stein GH (1980) Oligohydramnios and transient neonatal anuria: a possible association with the maternal use of prostaglandin synthetase inhibitors. J Reprod Med 24:220–223

    PubMed  CAS  Google Scholar 

  19. Chasnoff IJ, Hatcher R, Burns WJ, Schnoll SH (1983) Pentazocine and tripelennamine (‘T’s and blue’s’): effects on the fetus and neonate. Dev Pharmacol Ther 6:162–169

    PubMed  CAS  Google Scholar 

  20. Collins E (1981) Maternal and fetal effects of acetaminophen and salicylates in pregnancy. Obstet Gynecol 58 [Suppl]:57S–62S

    PubMed  CAS  Google Scholar 

  21. Courtney MA, Bader AM, Hartwell B, Hauch M, Grennan MJ, Datta S (1992) Perioperative analgesia with sufentanil with subarachnoid sufentanil administration. Regional Anesthesia 17:274–278

    PubMed  CAS  Google Scholar 

  22. Cousins MJ, Mather LE (1984) Intrathecal and epidural administration of opioids. Anesthesiology 61:276–310

    Article  PubMed  CAS  Google Scholar 

  23. Cox SR, Forbes KK (1987) Excretion of flurbiprofen into breast milk. Pharmacotherapy 7:211–215

    PubMed  CAS  Google Scholar 

  24. Dean M, Stock B, Patterson RJ, Levy G (1980) Serum protein binding of drugs during and after pregnancy in humans. Clin Pharmacol Ther 28:253–261

    Article  PubMed  CAS  Google Scholar 

  25. Eeg-Olofsson O, Malmros J, Elwin CE, Stéen B (1978) Convulsions in a breast-fed infant after maternal indomethacin. Lancet 2:215

    Article  PubMed  CAS  Google Scholar 

  26. Elis J, Sechserova M, Stribrny J, Drabkova J (1978) The distribution of sodium salicylate in the human fetus. Int J Clin Pharmacol Biopharm 16:365–367

    PubMed  CAS  Google Scholar 

  27. Feilberg VL, Rosenborg D, Broen Christensen C, Viby Mogensen J (1989) Excretion of morphine in human breast milk. Acta Anaesthesiol Scand 33:426–428

    Article  PubMed  CAS  Google Scholar 

  28. Findlay JWA, DeAngelis RL, Kearney MF, Welch RM, Findlay JM (1981) Analgesic drugs in breast milk and plasma. Clin Pharmacol Ther 29:625–633

    Article  PubMed  CAS  Google Scholar 

  29. Fowler PD (1979) Voltarol: diclofenac sodium. Clin Rheum Dis 5:427–464

    Google Scholar 

  30. Giesecke AH, Rice LJ, Lipton JM (1985) Alfentanil in colostrum. Anesthesiology 63:A284

    Article  Google Scholar 

  31. Golden NL, King KC, Sokol RJ (1982) Propoxyphene and acetaminophen. Possible effects on the fetus. Clin Pediatr 21:752–754

    Article  CAS  Google Scholar 

  32. Gustafsson LL, Schildt B, Jacobsen K (1982) Adverse effects of extradural and intrathecal opiates: report of a nationwide survey in Sweden. Br J Anaesth 54:479–486

    Article  PubMed  CAS  Google Scholar 

  33. Halle H, Hengst P (1978) Zusatztokolyse durch Prostaglandinsynthesehemmung mit Indometacin. Z Geburtshilfe Perinatol 182:367–370

    PubMed  CAS  Google Scholar 

  34. Harker LC, Kirkpatrick SE, Friedman WF, Bloor CM (1981) Effects of indomethacin on fetal rat lungs: a possible cause of persistant fetal circulation (PFC). Pediatr Res 15:147–151

    Article  PubMed  CAS  Google Scholar 

  35. Heinonen OP, Slone D, Shapiro S (1977) Birth defects and drugs in pregnancy. Publ Sciences Group Littleton, MA

    Google Scholar 

  36. Hunt CO, Naulty JS, Bader AM, Hauch MA, Vartikar JV, Datta S, Hertwig LM, Ostheimer GW (1989) Perioperative analgesia with subarachnoid fentanyl-bupivacaine for cesarean delivery. Anesthesiology 71:535–540

    Article  PubMed  CAS  Google Scholar 

  37. Itskovitz J, Abramovici H, Brandes JM (1980) Oligohydramnion, meconium and perinatal death concurrent with indomethacin treatment in human pregnancy. J Reprod Med 24:137–140

    PubMed  CAS  Google Scholar 

  38. Jacobson B, Eklund GG, Hamberger L, Linnarsson D, Sedvall GG, Valverius M (1987) Perinatal origin of adult self-destructive behaviour. Acta Psychiatr Scand 76:364–371

    Article  PubMed  CAS  Google Scholar 

  39. Jacobson B, Nyberg K, Eklund GG, Bygdeman M, Rydberg U (1988) Obstetric pain medication and eventual adult amphetamine addiction in offspring. Acta Obstet Gynecol Scand 67:677–682

    Article  PubMed  CAS  Google Scholar 

  40. Kileff ME, James FM, Dewan DM, Floyd HM (1984) Neonatal neurobehavioral responses after epidural anesthesia for cesarean section using lidocaine and bupivacaine. Anesth Analg 63:413–417

    Article  PubMed  CAS  Google Scholar 

  41. Knörr K, Knörr-Gärtner H (1981) Umwelteinflüsse auf die Kindesentwicklung. In: Käser O, Friedberg V, Ober KG, Thomsen K, Zander J (Hrsg) Gynäkologie und Geburtshilfe. 2. neubearb Aufl, Bd II/1. Thieme, Stuttgart New York, S 1.30–1.65

    Google Scholar 

  42. Lebedevs TH, Wojnar-Horton RE, Yapp P, Roberts MJ, Dusci LJ, Hackett LP, Ilett KF (1991) Excretion of indomethacin in breast milk. Br J Clin Pharmacol 32:751–754

    PubMed  CAS  Google Scholar 

  43. Lee JJ, Rubin AP (1993) Breast feeding and anaesthesia. Anaesthesia 48:616–625

    Article  PubMed  CAS  Google Scholar 

  44. Leicht CH, Hughes SC, Dailey A, Shnider SM, Rosen MA (1986) Epidural morphine sulfate for analgesia after cesarean section: a prospective report of 1000 patients. Anesthesiology 65:A366

    Article  Google Scholar 

  45. Leuschen MP, Wolf LJ, Rayburn WF (1990) Fentanyl excretion in breast milk. Clin Pharm 9:336–337

    PubMed  CAS  Google Scholar 

  46. Levin DL, Fixier DE, Morriss FC, Tyson J (1978) Morphologic analysis of the pulmonary vascular bed in infants exposed in utero to prostaglandin synthetase inhibitors. J Pediatr 92:478–483

    Article  PubMed  CAS  Google Scholar 

  47. Lovecchio JL, Krasner J, Yaffe SJ (1981) Serum protein binding of salicylate during pregnancy and the puerperium. Dev Pharmacol Ther 2:172–179

    PubMed  CAS  Google Scholar 

  48. Madej TH, Strunin L (1987) Comparison of epidural fentanyl with sufentanil. Analgesia and side effects after a single bolus dose during elective caesarean section. Anaesthesia 42:1156–1161

    Article  PubMed  CAS  Google Scholar 

  49. Milsap RL, Szefler SJ (1986) Special pharmacokinetic considerations in children. In: Evans WE, Schentag JJ, Jusko WJ (eds) Applied pharmacokinetics: principles of therapeutic drug monitoring, 2nd edn. Applied Therapeutics, Spokane, WA: pp 294–330

    Google Scholar 

  50. Naulty JS, Ostheimer GG., Datta S, Weiss JB (1983) Bupivacaine in breast milk following epidural anesthesia for vaginal delivery. Regional Anesthesia 8:44–45

    Google Scholar 

  51. Naumburg EG, Meny RG (1988) Breast milk opioids and neonatal apnea. Am J Dis Child 142:11–12

    PubMed  CAS  Google Scholar 

  52. Niederhoff H, Zahradnik HP (1983) Analgesics during pregnancy. Am J Med 75:117–120

    Article  PubMed  CAS  Google Scholar 

  53. Nomura T, Isa Y, Kurokawa N, Kanzaki T, Tanaka H, Tada E, Sakamoto Y (1984) Enhancement effects of barbital on the teratogenicity of aminopyrine. Toxicology 29:281–291

    Article  PubMed  CAS  Google Scholar 

  54. Notarianni LJ, Oldham HG, Bennett PN (1987) Passage of paracetamol into breast milk and its subsequent metabolism by the neonate. Br J Clin Pharmacol 24:63–67

    Article  PubMed  CAS  Google Scholar 

  55. Nunez L, Larrea JL, Aguado MG, Reque JA, Matorras R, Minguez JA (1983) Pregnancy in 20 patients with bioprosthetic valve replacement. Chest 84:26–28

    Article  PubMed  CAS  Google Scholar 

  56. Ostrea EM, Lynn SM, Wayne RN, Stryker JC (1980) Tissue distribution of morphine in the newborns of addicted monkeys and humans. Clinical implications. Dev Pharmacol Ther 1:163–170

    PubMed  CAS  Google Scholar 

  57. Peiker G, Müller B, Ihn W, Nöschel H (1980) Ausscheidung von Pethidin durch die Muttermilch. Zentralbl Gynaecol 102:537–541

    CAS  Google Scholar 

  58. Peterson RG (1985) Consequences associated with nonnarcotic analgesics in the fetus and newborn. Fed Proc 44:2309–2313

    PubMed  CAS  Google Scholar 

  59. Quinn PG, Kuhnert BR, Kaine CJ, Syracuse CD (1986) Measurement of meperidine and normeperidine in human breast milk by selected ion monitoring. Biomed Environ Mass Spectrom 13:133–135

    Article  PubMed  CAS  Google Scholar 

  60. Räkóczi I, Tihanyi K, Demeter J, Gáti I (1985) Effect of acetylsalicylic acid on prostacyclin production in throphoblast. Acta Physiol Hung 65:379–382

    PubMed  Google Scholar 

  61. Randall CL, Anton RF (1984) Aspirin reduces alcohol-induced prenatal mortality and malformations in mice. Alcoholism 8:513–515

    PubMed  CAS  Google Scholar 

  62. Rawal N, Arner S, Gustafsson LL, Allvin R (1987) Present state of extradural and intrathecal opioid analgesia in Sweden. A nationwide follow-up survey. Br J Anaesth 59:791–799

    Article  PubMed  CAS  Google Scholar 

  63. Robieux I, Koren GG, Vandenbergh H, Schneiderman J (1990) Morphine excretion in breast milk and resultant exposure of a nursing infant. Clin Toxicol 28:365–370

    Article  CAS  Google Scholar 

  64. Rumack CM, Guggenheim MA, Rumack BH, Peterson RG, Johnson ML, Braithwaite WR (1981) Neonatal intracranial hemorrhage and maternal use of aspirin. Obstet Gynecol 58 [Suppl]:52S–56S

    PubMed  CAS  Google Scholar 

  65. Scanlon JW, Ostheimer GW, Lurie AO, Brown WU, Weiss JB, Alper MH (1976) Neurobehavioral responses and drug concentrations in newborns after maternal epidural anesthesia with bupivacaine. Anesthesiology 45:400–405

    Article  PubMed  CAS  Google Scholar 

  66. Sioufi A, Stierlin H, Schweizer A, Botta L, Degen PH, Theobald W, Brechbuhler S (1982) Neuere Befunde zur klinisch relevanten Pharmakokinetik von Diclofenac Na. In: Kass E (Hrsg) Voltaren — neue Ergebnisse. Huber, Bern, S 19–30

    Google Scholar 

  67. Smith IJ, Hinson JL, Johnson VA, Brown RD, Cook SM, Whitt RT, Wilson JT (1989) Flurbiprofen in post-partum women: plasma and breast milk disposition. J Clin Pharmacol 29:174–184

    Article  PubMed  CAS  Google Scholar 

  68. Stuart MJ, Gross SJ, Elrad H, Graeber JE (1982) Effects of acetylsalicylic-acid ingestion on maternal and neonatal hemostasis. N Engl J Med 307:909–912

    Article  PubMed  CAS  Google Scholar 

  69. Szeto HH, Zervoudakis IA, Cederqvist LL, Inturrisi CE (1978) Amniotic fluid transfer of meperidine from maternal plasma in early pregnancy. Obstet Gynecol 52:59–62

    PubMed  CAS  Google Scholar 

  70. Todd PA, Sorkin EM (1988) Diclofenac sodium: a reappraisal of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy. Drugs 35:244–285

    Article  PubMed  CAS  Google Scholar 

  71. Townsend RJ, Benedetti TJ, Erickson SH, Cengiz C, Gillespie WR, Gschwend J, Albert KS (1984) Excretion of ibuprofen into breast milk. Am J Obstet Gynecol 149:184–186

    PubMed  CAS  Google Scholar 

  72. Valette A, Reme JM, Pontonnier G, Cros J (1980) Specific binding for opiate-like drugs in the placenta. Biochem Pharmacol 29:2657–2661

    Article  PubMed  CAS  Google Scholar 

  73. Valette A, Tafani M, Porthe G, Pontonnier G, Cros J (1983) Placental kappa binding site: interaction with dynorphin and its possible implication in hCG secretion. Life Sci 33 [Suppl 1]:523–526

    Article  PubMed  CAS  Google Scholar 

  74. Veersema D, de Jong PA, van Wijck JAM (1983) Indomethacin and the fetal renal nonfunction syndrome. Eur J Obstet Gynecol Reprod Biol 16:113–121

    Article  PubMed  CAS  Google Scholar 

  75. Wagner G (1978) Schwere intrauterine Wachstumsretardierung bei Heroinabusus der Mutter — Ein Fallbericht. Z Geburtshilfe Perinatol 182:462–464

    PubMed  CAS  Google Scholar 

  76. Walsh SW (1985) Preeclampsia: an imbalance in placental prostacyclin and thromboxane production. Am J Obstet Gynecol 152:335–340

    PubMed  CAS  Google Scholar 

  77. Wilson JT, Brown RD, Cherek DR, Dailey JW, Hilman B, Jobe PC, Manno BR, Manno JE, Redetzki HM, Stewart JJ (1980) Drug excretion in human breast milk: principles, pharmacokinetics and projected consequences. Clin Pharmacokinet 5:1–66

    Article  PubMed  CAS  Google Scholar 

  78. Wischnik A, Manth SM, Lloyd J, Bullingham R, Thompson JS (1989) The excretion of ketorolac tromethamine into breast milk after multiple oral dosing. Eur J Clin Pharmacol 36:521–524

    Article  PubMed  CAS  Google Scholar 

  79. Wittels B, Scott DT, Sinatra RS (1990) Exogenous opioids in human breast milk and acute neonatal neurobehavior: a preliminary study. Anesthesiology 73:864–869

    Article  PubMed  CAS  Google Scholar 

  80. Zeisler JA, Gaarder TD, De Mesquita SA (1986) Lidocaine excretion in breast milk. Drug Intell Clin Pharmacol 20:691–693

    CAS  Google Scholar 

  81. Zuckerman H, Shalev E, Gilad G, Katzuni E (1984) Further study of the inhibition of premature labor by indomethacin. Part I. J Perinat Med 12:19–23

    Article  PubMed  CAS  Google Scholar 

  82. Zuckerman H, Shalev E, Gilad G, Katzuni E (1984) Further study of the inhibition of premature labor by indomethacin. Part II: double-blind study. J Perinat Med 12:25–29

    Article  PubMed  CAS  Google Scholar 

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© 1994 Springer-Verlag Berlin Heidelberg

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Strasser, K. (1994). Schmerztherapie bei Schwangeren. In: Lehmann, K.A. (eds) Der postoperative Schmerz. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-21762-7_32

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  • DOI: https://doi.org/10.1007/978-3-662-21762-7_32

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