Der Chirurg

, Volume 83, Issue 4, pp 323–326

Anästhesie: Partner oder Konkurrent?



Chirurgie und Anästhesie waren schon immer eng miteinander verbunden. Durch die Entwicklung immer komplexer werdender Therapien und der zur Verfügung stehenden technischen Möglichkeiten überschneiden sich die beiden Fächer in vielen Bereichen. Dieser Artikel beschäftigt sich mit der Frage, inwieweit die Anästhesie als Konkurrent oder als Partner in der Zusammenarbeit mit den verschiedenen operativen Fachrichtungen gesehen werden kann. Es hat sich in mehreren Studien eindeutig belegen lassen, dass das Outcome chirurgischer Patienten durch Interaktion und Kommunikation mit der Anästhesie verbessert werden kann und dass die Bildung multidisziplinärer Teams auf der Intensivstation der einzige Weg sein wird, der dem Wohl unserer Patienten dient.


Anästhesie Chirurgie Partner Interdisziplinär Multidisziplinär 

Anesthesiology: partner or competitor?


Surgery and anesthesiology have always been closely connected. Within the increasing complexity of therapies and technical capabilities both subjects overlap in certain areas. This article deals with the question whether anesthesiology is acting as a partner or competitor in the cooperation with the various operative specialties. In several studies it has been shown that the outcome of surgical patients can be improved by communication and interaction with anesthesiology and that forming multidisciplinary teams will be highly beneficial for patients in intensive care units.


Anesthesiology Surgery Partner Interdisciplinary Multidisciplinary 


  1. 1.
    Amato A, Pescatori M (2006) Perioperative blood transfusions for the recurrence of colorectal cancer. Cochrane Database Syst Rev (1):CD005033Google Scholar
  2. 2.
    Bai HM, Wang WM, Wang SS et al (2011) Three core techniques in surgery of neuroepithelial tumors in eloquent areas: awake anaesthesia, intraoperative direct electrical stimulation and ultrasonography. Chin Med J 124:3035–3041PubMedGoogle Scholar
  3. 3.
    Biki B, Mascha E, Buggy DJ et al (2008) Anesthetic technique for radical prostatectomy surgery affects cancer recurrence: a retrospective analysis. Anesthesiology 109:180–187PubMedCrossRefGoogle Scholar
  4. 4.
    Carli F, Balsini G (2011) Fast-track surgery: it is time for the anesthesiologist to get involved! Minerva Anestesiol 77:227–230PubMedGoogle Scholar
  5. 5.
    Christopherson R, James KE, Johnson FE et al (2008) Long-term survival after colon cancer surgery: a variation associated with choice of anesthesia. Anesth Analg 107:325–332PubMedCrossRefGoogle Scholar
  6. 6.
    Eltzschig HK, Rosenberger P, Shernan SK et al (2008) Impact of intraoperative transesophageal echocardiography on surgical decisions in 12,566 patients undergoing cardiac surgery. Ann Thorac Surg 85:845–853PubMedCrossRefGoogle Scholar
  7. 7.
    Feng ZY, Xu X, Zheng SS et al (2010) Effects of low central venous pressure during preanhepatic phase on blood loss and liver and renal function in liver transplantation. World J Surg 34:1864–1873PubMedCrossRefGoogle Scholar
  8. 8.
    Fraga M, Rama-Maceiras P, Belda J et al (2003) The effects of isoflurane and desflurane on intracranial pressure, cerebral perfusion pressure, and cerebral arteriovenous oxygen content difference in normocapnic patients with supratentorial brain tumors. Anesthesiology 98:1085–1090PubMedCrossRefGoogle Scholar
  9. 9.
    Gajic O, Afessa B (2009) Physician staffing models and patient safety in the ICU. Chest 135:1038–1044PubMedCrossRefGoogle Scholar
  10. 10.
    Ghaferi AA, Birkmeyer JD, Dimick JB (2009) Variation in hospital mortality associated with inpatient surgery. N Engl J Med 361:1368–1375PubMedCrossRefGoogle Scholar
  11. 11.
    Gottschalk A, Ford JG, Regelin CC et al (2010) Association between epidural analgesia and cancer recurrence after colorectal cancer surgery. Anesthesiology 113:27–34PubMedCrossRefGoogle Scholar
  12. 12.
    Gottschalk A, Sharma S, Tiouririne M et al (2010) Review article: the role of the perioperative period in recurrence after cancer surgery. Anesth Analg 110:1636–1643PubMedCrossRefGoogle Scholar
  13. 13.
    Haynes AB, Weiser TG, Gawande AA et al (2009) A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 360:491–499PubMedCrossRefGoogle Scholar
  14. 14.
    Hecker A, Lichtenstern C, Weigand MA et al (2011) Moderne Organisationskonzepte interdisziplinärer operativer Intensivstationen. CHAZ 12:90–98Google Scholar
  15. 15.
    Herzer G, Trimmel H (2010) Neuroanästhesie. Anaesthesist 59:371–384PubMedCrossRefGoogle Scholar
  16. 16.
    Kim YK, Chin JH, Park JY et al (2009) Association between central venous pressure and blood loss during hepatic resection in 984 living donors. Acta Anaesthesiol Scand 53:601–606PubMedCrossRefGoogle Scholar
  17. 17.
    Klar E, Püschel A, Pertschy A et al (2009) Rolle der Intensivmedizin bei frühen postoperativen Komplikationen. Chirurg 80:1–6CrossRefGoogle Scholar
  18. 18.
    Linke GR, Mieth M, Büchler MW et al (2011) Surgical intensive care unit – essential for good outcome in major abdominal surgery? Langenbecks Arch Surg 396:417–428PubMedCrossRefGoogle Scholar
  19. 19.
    Matot I, Scheinin O, Eid A et al (2002) Effectiveness of acute normovolemic hemodilution to minimize allogeneic blood transfusion in major liver resections. Anesthesiology 97:794–800PubMedCrossRefGoogle Scholar
  20. 20.
    Naqash I, Draboo MA, Bhat AR (2011) Evaluation of acute normovolemic hemodilution and autotransfusion in neurosurgical patients undergoing excision of intracranial meningioma. J Anaesthesiol Clin Pharmacol 27:54–58PubMedGoogle Scholar
  21. 21.
    Pereira LCM, Oliveira KM, Motta LA da et al (2009) Outcome of fully awake craniotomy for lesions near the eloquent cortex: analysis of a prospective surgical series of 79 supratentorial primary brain tumors with long follow-up. Acta Neurochir 151:1215–1230CrossRefGoogle Scholar
  22. 22.
    Petersen K, Landsfeldt U, Olsen KS (2003) Intracranial pressure and cerebral hemodynamic in patients with cerebral tumors. Anesthesiology 98:329–336PubMedCrossRefGoogle Scholar
  23. 23.
    Rahbari NN, Zimmermann JB, Weitz J et al (2009) Meta-analysis of standard, restrictive and supplemental fluid administration in colorectal surgery. Br J Surg 96:331–341PubMedCrossRefGoogle Scholar
  24. 24.
    Ryu HG, Nahm FS, Jung CW et al (2010) Low central venous pressure with milrinone during living donor hepatectomy. Am J Transplant 10:877–882PubMedCrossRefGoogle Scholar
  25. 25.
    Schmid E, Nowak M, Rosenberger P et al (2009) Intraoperative Echokardiographie – Einfluss auf das chirurgische Management. Anaesthesist 58:1123–1135PubMedCrossRefGoogle Scholar
  26. 26.
    Stürmer KM, Neugebauer E et al (2011) S 3 Leitlinie Polytrauma. AWMF 07/2011; Reg.Nr:012/019Google Scholar
  27. 27.
    Vries EN, Prins HA, Boermeester MA et al (2010) Effect of a comprehensive surgical safety system on patient outcomes. N Engl J Med 363:1928–1937PubMedCrossRefGoogle Scholar
  28. 28.
    Weitz J, Weigand MA, Martin E et al (2006) Stellenwert der Anästhesie in multimodalen onkologischen Therapiekonzepten. Anaesthesist 55:1299–1306PubMedCrossRefGoogle Scholar
  29. 29.
    White PF, Kehlet H, Carli F et al (2007) The role of the anesthesiologist in fast-track surgery: from multimodal analgesia to perioperative medical care. Anesth Analg 104:1380–1396PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Klinik für Anaesthesiologie, operative Intensivmedizin und SchmerztherapieUniversitätsklinikum Gießen & Marburg GmbH, Standort GießenGießenDeutschland
  2. 2.Klinik für AnaesthesiologieUniversitätsklinikum HeidelbergHeidelbergDeutschland

Personalised recommendations