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Medikamente zur postoperativen Schmerztherapie: Bewährtes und Neues

Teil 1: Nichtopioide

Drugs for postoperative analgesia: routine and new aspects

Part 1: Non-opioids

  • Klinische Pharmakologie
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Zusammenfassung

Im ersten Teil des Übersichtsartikels werden perioperative Aspekte der Anwendung von Nichtopioiden (Paracetamol, Metamizol, traditionelle nichtsteroidale antiphlogistische Rheumatika, Coxibe) diskutiert; im zweiten Teil folgen die Opioide (schwach: Tramadol, Tilidin mit Naloxon; stark: Piritramid, Morphin, Oxycodon, Hydromorphon, Fentanyl, Methadon, Buprenorphin) und einige Koanalgetika (Gabapentinoide, Ketamin). Zentraler Punkt der Übersicht ist die Darstellung von Nutzen und Risiken der Substanzen (Analgesie vs. Nebenwirkungen), um dem Anwender die Differenzialindikation bei Patienten mit renalen, gastrointestinalen, kardiozirkulatorischen oder hepatischen Vorerkrankungen zu erleichtern. Neue Aspekte der Anwendung von Gabapentinoiden und Ketamin werden ebenfalls diskutiert.

Abstract

In part 1 of this review the perioperative aspects of the use of non-opioids (acetaminophen, dipyrone, traditional NSAR, coxibs) and in part 2 of opioids (weak opioids: tramadol, tilidine with naloxone, strong opioids: morphine, piritramide, oxycodone, hydromorphone, fentanyl, methadone, buprenorphine) and coanalgesics (gabapentinoids, ketamine) will be discussed. The main aim is to describe the relationship between analgesic efficacy and side effects to make clinical decisions easier in patients with preoperative renal, gastrointestinal, cardiovascular and other diseases. Some new aspects concerning perioperative administration of gabapentinoids and ketamine in patients with perioperative neuropathic pain are discussed.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung/en hin: Der korrespondierende Autor hat Vorträge auf Honorarbasis für die Firmen Avenits, Bristol Myers-Squibb, Grünenthal, Janssen-Cilag, MSD, Mundipharma gehalten.

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  1. Klinik für Anästhesiologie, Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131, Mainz, Deutschland

    J. Jage, R. Laufenberg-Feldmann & F. Heid

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  1. J. Jage
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  2. R. Laufenberg-Feldmann
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  3. F. Heid
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Correspondence to J. Jage.

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Der zweite Teil dieses Beitrags zum Thema „Opioide, Ketamin und Gabapentinoide“ erscheint in Ausgabe 05/2008 dieser Zeitschrift.

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Jage, J., Laufenberg-Feldmann, R. & Heid, F. Medikamente zur postoperativen Schmerztherapie: Bewährtes und Neues. Anaesthesist 57, 382–390 (2008). https://doi.org/10.1007/s00101-008-1326-x

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  • DOI: https://doi.org/10.1007/s00101-008-1326-x

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