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Periduralanästhesie

Epidural anesthesia

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An Erratum to this article was published on 18 July 2007

Zusammenfassung

Als Peri- oder Epiduralanästhesie (PDA) bezeichnet man die Injektion therapeutisch wirksamer Substanzen in den der Dura mater spinalis außen angrenzenden Epiduralraum mit dem Ziel, eine sensorische und evtl. motorische Blockade zu erzielen. Sie zählt damit zu den so genannten „zentralen“ oder „neuroaxialen“ Regionalverfahren und ist eine der ältesten Anästhesietechniken überhaupt. Ursprünglich wurden ausschließlich Lokalanästhetika verwendet. Durch den Zusatz anderer Medikamente, den Einsatz auch in Kombination mit einer Allgemeinanästhesie oder die Anwendung bei kleinen Kindern wurde das Indikationsspektrum erweitert. Die kontinuierliche Katheterperiduralanalgesie hat in der postoperativen Phase einen festen Stellenwert. Der zunehmende Anteil von Patienten mit Begleiterkrankungen oder einer gerinnungsmodulierenden Dauertherapie erfordert immer häufiger eine Nutzen-Risiko-Abwägung vor dem Einsatz der PDA.

Abstract

In epidural anaesthesia, the anaesthetist injects one or more drugs into the epidural space bordering on the spinal dura mater to achieve a “central” and/or “neuraxial” block. It is one of the earliest techniques in anaesthesia, originally performed exclusively with local anaesthetic agents. Adding other drugs and combining epidural with general anaesthesia or adapting the technique to the needs of children has extended the list of indications. Continuous epidural analgesia is an important tool in postoperative pain management. More and more often, the increasing proportion of patients who have comorbidities or are permanently taking medication that modulates the clotting system demands that the anaesthesiologist balance the individual risks and benefits before inducing epidural anaesthesia.

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Danksagung

Wir bedanken uns bei Dr. Martin Jöhr, Luzern, für seine wertvollen Anmerkungen zum Abschnitt „Periduralanästhesie im Kindesalter“.

Interessenkonflikt

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

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Correspondence to F. Gerheuser.

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Der vorliegende Beitrag basiert auf: Craß D, Gerheuser F (2004) Regionalanästhesie. In: Rossaint R, Werner C, Zwissler B (Hrsg) Die Anästhesiologie, 1. Aufl. Springer, Berlin Heidelberg New York, S 621–726

Inhaltliche Überschneidungen mit folgendem Artikel wurden der inhaltlichen Vollständigkeit zuliebe in Kauf genommen: Gerheuser F, Craß D (2005) Spinalanästhesie. Anästhesist 54: 1245–1270

Ein Erratum zu diesem Beitrag ist unter http://dx.doi.org/10.1007/s00101-007-1228-3 zu finden.

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Gerheuser, F., Roth , A. Periduralanästhesie. Anaesthesist 56, 499–526 (2007). https://doi.org/10.1007/s00101-007-1181-1

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