Der Anaesthesist

, Volume 56, Issue 12, pp 1223–1230 | Cite as

Elektive Kolonresektionen in Deutschland

Umfrage zum perioperativen anästhesiologischen Management
  • T. Hasenberg
  • M. Niedergethmann
  • P. Rittler
  • S. Post
  • K.W. Jauch
  • M. Senkal
  • C. Spies
  • W. Schwenk
  • E. Shang
Originalien

Zusammenfassung

Hintergrund

Die „Fast-Track“-Rehabilitation im Rahmen elektiver Kolonresektionen ist ein multimodales, perioperatives Behandlungskonzept, das chirurgische und anästhesiologische Aspekte kombiniert. Dadurch wird die Rate allgemeiner Komplikationen vermindert und eine rasche Rekonvaleszenz ermöglicht. Die hier vorgestellte Umfrage untersucht die Verbreitung und die Anwendung dieses Konzeptes in Deutschland.

Methoden

Im Januar 2006 erhielten 1270 anästhesiologische Abteilungen einen Fragebogen, in dem das übliche anästhesiologische Vorgehen anhand einer konventionellen Sigmaresektion beschrieben werden sollte.

Ergebnisse

Die Rücklaufrate betrug 385 (30,3%). Es wird eine präoperative Nahrungskarenz bezüglich fester Kost von 12 h vor dem Eingriff in 52% und von 6 h in 44% der Kliniken eingehalten; bezüglich der Aufnahme von Flüssigkeiten beträgt die Karenzzeit 6 h in 47% und 2 h 41% in der Kliniken. Eine Prophylaxe gegen postoperative Übelkeit und Erbrechen („postoperative nausea and vomiting“, PONV) führen 33% der Befragten durch. Propofol (68%) ist das führende Narkotikum. Fentanyl (56%) und Sufentanil (48%) sind die am weitesten verbreiteten Analgetika. Es nutzen 75% der anästhesiologischen Abteilungen epidurale Analgesien.

Schlussfolgerung

In Deutschland orientiert sich die anästhesiologische Versorgung im Rahmen elektiver Kolonresektionen in weiten Teilen an den evidenzbasierten Empfehlungen zur „Fast-Track“-Chirurgie.

Schlüsselwörter

Kolonresektion Fast-track Early recovery after surgery Umfrage Deutschland Anästhesiologie 

Elective colon resection in Germany

A survey of the perioperative anesthesiological management

Abstract

Background

Fast-track rehabilitation after elective colon resection is an interdisciplinary multimodal procedure, which combines surgical and anesthesiological aspects. This leads to an improved and accelerated recovery and avoids perioperative complications. This survey focuses on the extent and use of such concepts in Germany.

Methods

In January 2006, a questionnaire was sent to 1270 anesthesiology departments in Germany in which they were asked to describe the standard anesthesia procedures based on a conventional sigmoid resection.

Results

The response rate was 385 out of 1270 (30.3%). Preoperative fasting of solid food 12 h before the operation was practiced in 52% and for 6 h in 44% of the clinics. For fluid intake the fasting time was 6 h in 47% and 2 h in 41%. Prophylactic measures for postoperative nausea and vomiting (PONV) were administered in 33% of clinics. Propofol (68%) was the leading narcotic, fentanyl (56%) and sufentanil (48%) were the most commonly used intraoperative analgesics and 75% of clinics used epidural analgesia.

Conclusion

In Germany the anesthesiological treatment after elective colon surgery adheres broadly to the evidence-based recommendations for fast-track concepts.

Keywords

Colon resection Fast-track program Early recovery after surgery Survey Germany Anesthesiology 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  • T. Hasenberg
    • 1
  • M. Niedergethmann
    • 1
  • P. Rittler
    • 2
  • S. Post
    • 1
  • K.W. Jauch
    • 2
  • M. Senkal
    • 3
  • C. Spies
    • 4
  • W. Schwenk
    • 5
  • E. Shang
    • 1
  1. 1.Chirurgische UniversitätsklinikKlinikum Mannheim gGmbHMannheimDeutschland
  2. 2.Chirurgische Klinik und Poliklinik GroßhadernKlinikum der Universität MünchenMünchenDeutschland
  3. 3.Allgemeinchirurgische KlinikMarienhospital WittenWittenDeutschland
  4. 4.Universitätsklinik für Anästhesiologie und operative IntensivmedizinUniversitätsmedizin Berlin – Charité Campus Mitte und Campus Virchow-KlinikumBerlinDeutschland
  5. 5.Universitätsklinik für Allgemein-, Visceral-, Gefäß- und ThoraxchirurgieUniversitätsmedizin Berlin – Charité, Campus MitteBerlinDeutschland

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