Zusammenfassung
Die geburtshilfliche anästhesiologische Tätigkeit umfasst heute neben der Betreuung von Patientinnen im Kreißsaal durch vornehmlich regionalanästhesiologische Methoden zur Schmerzbehandlung während der Geburt sowie der Durchführung von Anästhesien zur Sectio caesarea zunehmend die Mitwirkung und Durchführung von interdisziplinären, präpartalen Therapiekonzepten bei Schwangeren mit schwangerschaftsassoziierten oder schwangerschaftsunabhängigen Erkrankungen. Akutsituationen wie z. B. die Notfallsectio oder postpartale Blutungen erfordern ein hohes Maß an Fachwissen, aber auch definierte und trainierte Standards sowie eine gute Kommunikation. Vor dem Hintergrund einer evidenzbasierten Vorgehensweise ist zudem die Integration nationaler und internationaler Empfehlungen und Leitlinien Ausdruck einer zeitgemäßen Patientenversorgung. Diese Umstände erfordern zwingend eine reibungslose interdisziplinäre sowie interprofessionelle Zusammenarbeit von Geburtshelfern, Hebammen, Pflegepersonal und Anästhesisten als unverzichtbares Merkmal einer modernen, auf die betreuten Patientinnen zentrierte, Geburtshilfe.
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Literatur
American College of Obstetricians and Gynecologists (2017) Practice bulletin no. 177: obstetric analgesia and anesthesia. Obstet Gynecol 129:e73–e89
American College of Obstetricians and Gynecologists (ACOG) (2019) Practice Bulletin no. 209: obstetric Analgesia and Anesthesia. Obstet Gynecol 133:e208–e225
Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A (2018) Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev 5(CD000331)
Aust H, Koehler S, Kuehnert M, Wiesmann T (2016) Guideline-recommended 15° left lateral table tilt during cesarean section in regional anesthesia – practical aspects: an observational study. J Clin Anesth 32:47–53
AWMF (2018) Hypertensive Schwangerschaftserkrankungen: Diagnostik und Therapie. https://www.awmf.org/leitlinien/detail/ll/015-018.html. Zugegriffen am 30.11.2021
AWMF (2020a) Sectio caesarea. https://www.awmf.org/uploads/tx_szleitlinien/015-084k_S3_Sectio-caesarea_2020-06_1_02.pdf. Zugegriffen am 30.11.2021
AWMF (2020b) Intravasale Volumentherapie beim Erwachsenen. https://www.awmf.org/leitlinien/detail/ll/001-020.html. Zugegriffen am 30.11.2021
AWMF (2021) Die vaginale Geburt am Termin. https://www.awmf.org/leitlinien/detail/ll/015-083.html. Zugegriffen am 30.11.2021
Aziz MF, Healy D, Kheterpal S, Fu RF, Dillman D, Brambrink AM (2011) Routine clinical practice effectiveness of the Glidescope in difficult airway management: an analysis of 2,004 Glidescope intubations, complications, and failures from two institutions. J Am Soc Anesthesiol 114:34–41
Banerjee A, Cantellow S (2021) Maternal critical care: Part I. BJA Educ 21:140–147
Bauer ME, Mhyre JM (2016) Active management of labor epidural analgesia is the key to successful conversion of epidural analgesia to cesarean delivery anesthesia. Anesth Analg 123:1074–1076
Bauer ME, Kountanis JA, Tsen LC, Greenfield ML, Mhyre JM (2012) Risk factors for failed conversion of labor epidural analgesia to cesarean delivery anesthesia: a systematic review and meta-analysis of observational trials. Int J Obstet Anesth 21:294–309
Bauer ME, Arendt K, Beilin Y, Gernsheimer T, Perez Botero J, James AH, Yaghmour E, Toledano RD, Turrentine M, Houle T, MacEachern M, Madden H, Rajasekhar A, Segal S, Wu C, Cooper JP, Landau R, Leffert L (2021) The Society for obstetric anesthesia and perinatology interdisciplinary consensus statement on neuraxial procedures in obstetric patients with thrombocytopenia. Anesth Analg 132:1531–1544
Becke K, Jöhr M, Girard T (2019) Einleitung von nicht nüchternen Patienten am Beispiel von Schwangeren und Kindern. Anasthesiol Intensivmed Notfallmed Schmerzther 54:617–628
Biehl DR, Yarnell R, Wade JG, Sitar D (1983) The uptake of ISO-flurane by the foetal lamb in utero: effect on regional blood flow. Can Anaesth Soc J 30:581–586
Bishton IM, Martin PH, Vernon JM, Liu WHD (1992) Factors influencing epidural catheter migration. Anaesthesia 47:610–612
Bláha J, Nosková P, Hlinecká K, Krakovská V, Fundová V, Bartošová T, Michálek P, Stříteský M (2020) Surgical conditions with rocuronium versus suxamethonium in cesarean section: a randomized trial. Int J Obstet Anesth 41:14–21
Bremerich D, Annecke T, Chappell D, Hans R, Kaufner L, Kehl F, Kranke P, Girard T, Gogarten W, Greve S, Neuhaus S, Schlembach D, Schlösser L, Standl T, Volk T, Wallenborn J, Weber S, Wenk M (2020) Die geburtshilfliche Analgesie und Anästhesie. S1-Leitlinie der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin in Zusammenarbeit mit der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe. Anästhesiologie Intensivmedizin 61:S300–S339
Campbell M, Pierce JMT (2015) Atmospheric science, anaesthesia, and the environment. BJA Educ 15:173–179
Carstoniu J, Levytam S, Norman P, Daley D, Katz J, Sandler AN (1994) Nitrous oxide in early labor. Safety and analgesic efficacy assessed by a double-blind, placebo-controlled study. Anesthesiology 80:30–35
Carvalho B, Mhyre JM (2019) Centers of excellence for anesthesia care of obstetric patients. Anesth Analg 128:844–846
Chappell D, Kranke P, Jedlicka J (2017) Anästhesie zur Kaiserschnittentbindung. In: Kranke P (Hrsg) Die geburtshilfliche Anästhesie. Springer, Berlin, Heidelberg
Chau A, Bibbo C, Huang CC, Elterman KG, Cappiello EC, Robinson JN, Tsen LC (2017) Dural puncture epidural technique improves labor analgesia quality with fewer side effects compared with epidural and combined spinal epidural techniques: a randomized clinical trial. Anesth Analg 124:560–569
Clark K, Lam LT, Gibson S, Currow D (2009) The effect of ranitidine versus proton pump inhibitors on gastric secretions: a meta-analysis of randomised control trials. Anaesthesia 64:652–657
D’Angelo R, Smiley RM, Riley ET, Segal S (2014) Serious complications related to obstetric anesthesia: the serious complication repository project of the Society for Obstetric Anesthesia and Perinatology. Anesthesiology 120:1505–1512
Dell-Kuster S, Levano S, Burkhart CS, Lelais F, Zemp A, Schobinger E, Hampl K, Kindler C, Girard T (2015) Predictors of the variability in neuromuscular block duration following succinylcholine: a prospective, observational study. Eur J Anaesthesiol 32:687–696
Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (1996) Vereinbarung über die Zusammenarbeit in der operativen Gynäkologie und in der Geburtshilfe. Anaesth Intensivmed 37:414–418
Giannina G, Guzman ER, Lai YL, Lake MF, Cernadas M, Vintzileos AM (1995) Comparison of the effects of meperidine and nalbuphine on intrapartum fetal heart rate tracings. Obstet Gynecol 86:441–445
Gin T, Gregory MA, Chan K, Oh TE (1990) Maternal and fetal levels of propofol at caesarean section. Anaesth Intensive Care 18:180–184
Girard T, Heim C, Hornung R, Hösli I, Krayer S, Panchard M-A, Pfister R, Schär G, Schipani S (2016) Neonatale Erstversorgung–interdisziplinäre Empfehlungen. Swiss Med Forum 16:938–942
Goerig M, Wulf H (2017) Geschichte der geburtshilflichen Anästhesie. In: Kranke P (Hrsg) Die geburtshilfliche Anästhesie. Springer, Berlin, Heidelberg
Gogarten W, Vandermeulen E, Van Aken H, Kozek S, Llau JV, Samama CM, European SOA (2010) Regional anaesthesia and antithrombotic agents: recommendations of the European Society of Anaesthesiology. Eur J Anaesthesiol 27:999–1015
Hauptfleisch JJ, Payne KA (1996) An oral sodium citrate-citric acid non-particulate buffer in humans. Br J Anaesth 77:642–644
Hawkins JL, Chang J, Palmer SK, Gibbs CP, Callaghan WM (2011) Anesthesia-related maternal mortality in the United States: 1979–2002. Obstet Gynecol 117:69–74
Heesen M, Rijs K, Rossaint R, Klimek M (2019) Dural puncture epidural versus conventional epidural block for labor analgesia: a systematic review of randomized controlled trials. Int J Obstet Anesth 40:24–31
Hillyard SG, Bate TE, Corcoran TB, Paech MJ, O’Sullivan G (2011) Extending epidural analgesia for emergency Caesarean section: a meta-analysis. Br J Anaesth 107:668–678
Jansen S, Lopriore E, Naaktgeboren C, Sueters M, Limpens J, Van Leeuwen E, Bekker V (2020) Epidural-related fever and maternal and neonatal morbidity: a systematic review and meta-analysis. Neonatology 117:259–270
Kan RE, Hughes SC, Rosen MA, Kessin C, Preston PG, Lobo EP (1998) Intravenous remifentanil: placental transfer, maternal and neonatal effects. J Am Soc Anesthesiol 88:1467–1474
Kee WDN, Khaw KS, Ma ML, Mainland P-A, Gin T (1997) Postoperative analgesic requirement after cesarean section: a comparison of anesthetic induction with ketamine or thiopental. Anesth Analg 85:1294–1298
Kerwat K, Schulz-Stübner S, Steinfeldt T, Kessler P, Volk T, Gastmeier P, Geffers C, Ermert T, Boschin MG, Wiesmann T (2015) Hygieneempfehlungen für die Regionalanästhesie. Anästh Intensivmed 56:34–40
Khemlani KH, Weibel S, Kranke P, Schreiber J-U (2018) Hypnotic agents for induction of general anesthesia in cesarean section patients: a systematic review and meta-analysis of randomized controlled trials. J Clin Anesth 48:73–80
Kinsella SM (2008) A prospective audit of regional anaesthesia failure in 5080 Caesarean sections. Anaesthesia 63:822–832
Kinsella SM, Lohmann G (1994) Supine hypotensive syndrome. Obstet Gynecol 83:774–788
Kinsella SM, Winton AL, Mushambi MC, Ramaswamy K, Swales H, Quinn AC, Popat M (2015) Failed tracheal intubation during obstetric general anaesthesia: a literature review. Int J Obstet Anesth 24:356–374
Knight M, Bunch K, Tuffnell D, Shakespeare J, Kotnis R, Kenyon S, Kurinczuk JJ, on behalf of MBRRACE-UK. Saving Lives (Hrsg) (2019) Improving Mothers’ care-lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2015–17. National Perinatal Epidemiology Unit, University of Oxford, Berlin, Heidelberg
Kopp R, Schuerholz T, Asche P, Rossaint R, Marx G (2012) Intensivstation und Intermediate Care unter einem Dach. Anästhesiol Intensivmed 53:598
Kranke P (Hrsg) (2018) Die geburtshilfliche Anästhesie. Springer
Krom AJ, Cohen Y, Miller JP, Ezri T, Halpern SH, Ginosar Y (2017) Choice of anaesthesia for category-1 caesarean section in women with anticipated difficult tracheal intubation: the use of decision analysis. Anaesthesia 72:156–171
La Rosa M, Piva L, Ravanelli A, Dindelli M, Pagnoni B (1992) Aspiration syndrome in cesarean section. Our experience from 1980 to 1990. Minerva Anestesiol 58:1213–1220
Massoth C, Chappell D, Kranke P, Wenk M (2022) Supine hypotensive syndrome of pregnancy: A review of current knowledge. Eur J Anaesthesiol 39:236–243
Melchor JR, Espinosa Á, Hurtado EM, Frances RC, Perez RN, Gurumeta AA, Vecino JC (2015) Colloids versus crystalloids in the prevention of hypotension induced by spinal anesthesia in elective cesarean section. A systematic review and meta-analysis. Minerva Anestesiol 81:1019–1030
Moen V, Dahlgren N, Irestedt L (2004) Severe neurological complications after central neuraxial blockades in Sweden 1990–1999. J Am Soc Anesthesiol 101:950–959
Morgan DJ, Blackman GL, Paull JD, Wolf LJ (1981) Pharmacokinetics and plasma binding of thiopental. II: studies at cesarean section. Anesthesiology 54:474–480
Mushambi MC, Kinsella SM, Popat M, Swales H, Ramaswamy KK, Winton AL, Quinn AC (2015) Obstetric Anaesthetists’ Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia 70:1286–1306
National Institute for Health and Care Excellence (2014) Intrapartum care: care of healthy women and their babies during childbirth. www.nice.org.uk/guidance/cg190. Zugegriffen am 26.10.2021
Nicolle E, Devillier P, Delanoy B, Durand C, Bessard G (1996) Therapeutic monitoring of nalbuphine: transplacental transfer and estimated pharmacokinetics in the neonate. Eur J Clin Pharmacol 49:485–489
Nielsen JD, Holasek J (1982) Ketamine as induction agent for caesarean section. Acta Anaesthesiol Scand 26:139–142
Olsson GL, Hallen B, Hambraeus-Jonzon K (1986) Aspiration during anaesthesia: a computer-aided study of 185 358 anaesthetics. Acta Anaesthesiol Scand 30:84–92
Palmer E, Ciechanowicz S, Reeve A, Harris S, Wong DJN, Sultan P (2018) Operating room-to-incision interval and neonatal outcome in emergency caesarean section: a retrospective 5-year cohort study. Anaesthesia 73:825–831
Pandit JJ, Andrade J, Bogod DG, Hitchman JM, Jonker WR, Lucas N, Mackay JH, Nimmo AF, O’Connor K, O’Sullivan EP, Paul RG, Palmer JH, Plaat F, Radcliffe JJ, Sury MR, Torevell HE, Wang M, Hainsworth J, Cook TM, Royal College of Anaesthetists, Association of Anaesthetists of Great Britain and Ireland (2014) 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors. Br J Anaesth 113:549–559
Piepho T, Cavus E, Noppens R, Byhahn C, Dörges V, Zwissler B, Timmermann A (2015) S1-Leitlinie Atemwegsmanagement. Anaesthesist 64:859–873
Rall M, Gaba DM, Howard SK, Dieckmann P (2005) Human performance and patient safety. Miller’s Anesthesia 6:3021–3072
Roofthooft E, Joshi GP, Rawal N, Van de Velde M, PROSPECT WGOTESORAAPTASBTOAA (2021) PROSPECT guideline for elective caesarean section: updated systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia 76:665–680
Ruppen W, Derry S, McQuay H, Moore RA (2006) Incidence of epidural hematoma, infection, and neurologic injury in obstetric patients with epidural analgesia/anesthesia. J Am Soc Anesthesiol 105:394–399
Russell R, Laxton C, Lucas DN, Niewiarowski J, Scrutton M, Stocks G (2019) Treatment of obstetric post-dural puncture headache. Part 2: epidural blood patch. Int J Obstet Anesth 38:104–118
Schnabel A, Hahn N, Muellenbach R, Frambach T, Hoenig A, Roewer N, Kranke P (2011) Geburtshilfliche Analgesie in deutschen Kliniken. Anaesthesist 60:995–1001
Schott C, Schmidt H (1998) Allgemeinanästhesie in der Schwangerschaft. Der Gynäkologe 31:910–921
Sharma SK, Sidawi EJ, Ramin SM, Lucas MJ, Leveno KJ, Cunningham GF (1997) Cesarean delivery: a randomized trial of epidural versus patient-controlled meperidine analgesia during labor. J Am Soc Anesthesiol 87:487–494
Singh S, McGlennan A, England A, Simons R (2012) A validation study of the CEMACH recommended modified early obstetric warning system (MEOWS). Anaesthesia 67:12–18
Smith I, Kranke P, Murat I, Smith A, O’Sullivan G, Søreide E, Spies C (2011) Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol 28:556–569
Standl T, Wilhelm S, Gnirke A, Hüneke B (1999) Recent developments in obstetric regional anesthesia. A review of experiences at the Eppendorf University Hospital. Anasthesiol Intensivmed Notfallmed Schmerzther 34:648–658
Sultan P, David AL, Fernando R, Ackland GL (2016) Inflammation and epidural-related maternal fever: proposed mechanisms. Anesth Analg 122:1546–1553
Tan EK, Tan EL (2013) Alterations in physiology and anatomy during pregnancy. Best Pract Res Clin Obstet Gynaecol 27:791–802
Valtonen M, Kanto J, Rosenberg P (1989) Comparison of propofol and thiopentone for induction of anaesthesia for elective caesarean section. Anaesthesia 44:758–762
Van Aken H, Biermann E, Bremerich D, Kessler P (2016) Zur Frage der postoperativen Überwachung von Kaiserschnittpatientinnen. Anästhesiol Intensivmed 57:47–50
Wallenborn J, Kranke P (2017) Analgesie zur Spontangeburt. In: Kranke P (Hrsg) Die geburtshilfliche Anästhesie. Springer, Berlin, Heidelberg
Wanna O, Werawatganon T, Piriyakitphaiboon S, Taesiri B (2004) A comparison of propofol and ketamine as induction agents for cesarean section. J Med Assoc Thail Chotmaihet thangphaet 87:774–779
WHO (2018) WHO recommendations: intrapartum care for a positive childbirth experience. https://apps.who.int/iris/bitstream/handle/10665/272447/WHO-RHR-18.12-eng.pdf. Zugegriffen am 26.10.2021, 12:56
Wiesmann T, Schubert AK, Volk T, Kubulus C, Zausig Y, Graf BM, Steinfeldt T (2020) Prevention & therapy of local anaesthetic systemic toxicity (LAST) Updated action recommendations of the scientific working group of regional anaesthesia of the German Society of Anaesthesiology and Intensive Care Medicine. Anästhesiol Intensivmed 61:225–238
Wilhelm W (2018) Praxis der Anästhesiologie. Springer, Berlin, Heidelberg
Wilson SJ, Errick JK, Balkon J (1986) Pharmacokinetics of nalbuphine during parturition. Am J Obstet Gynecol 155:340–344
Zettl A, Girard T (2017) Anästhesiologische Komplikationen. In: Kranke P (Hrsg) Die geburtshilfliche Anästhesie. Springer, Berlin, Heidelberg
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Kranke, P., Greve, S., Moertl, M.G., Lewald, H., Girard, T. (2022). Anästhesie und Analgesie in der Geburtshilfe. In: von Kaisenberg, C., Klaritsch, P., Hösli-Krais, I. (eds) Die Geburtshilfe. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44369-9_42-2
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Anästhesie und Analgesie in der Geburtshilfe- Published:
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