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Periphere Nervenblockaden an der unteren Extremität

Klinisch-praktische Aspekte

Peripheral nerve blocks of the lower extremities

Clinical and practical aspects

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Zusammenfassung

Periphere Nervenblockaden (PNB) an der unteren Extremität sind effektive Techniken für die Anästhesie und die postoperative Schmerztherapie. Dennoch wurden diese Blockadetechniken bisher deutlich seltener eingesetzt und auch gelehrt als PNB an der oberen Extremität. Zunehmende Beschäftigung mit den Komplikationen neuroaxialer Verfahren, verbesserte Materialien und moderne Verfahren zur Nervenlokalisation haben zur Erweiterung des Indikationsspektrums der PNB an der unteren Extremität geführt. Anästhesisten sollten neben den anatomischen Grundlagen und technischen Details der Durchführung auch die Komplikationen sowie Nebenwirkungen der PNB kennen und ihre Patienten detailliert über diese aufklären. Kontinuierliche PNB (Katheterverfahren) erlauben die Ausdehnung der positiven Effekte in die postoperative Phase. Kontinuierliche PNB haben im Vergleich zu kontinuierlichen neuroaxialen Techniken bei vergleichbarer Wirksamkeit Vorteile in Bezug auf Komplikationen und Nebenwirkungen.

Abstract

Peripheral nerve blocks (PNBs) of the lower extremities are effective techniques for anesthesia and postoperative pain control. So far, these techniques have been used less frequently than PNBs of the upper limb. Nevertheless, growing awareness of complications of neuroaxial techniques, improved equipment and modern techniques for nerve localization have led to an increased use of PNBs of the lower limb. Anesthesiologists should be familiar with the anatomical basics and procedural details of these PNBs. They should also know the typical complications and side-effects and thoroughly inform patients about such potential problems. Continuous PNBs (perineural catheters) allow the benefits of PNBs to be prolonged into the postoperative period. Compared to continuous neuroaxial techniques continuous PNBs are equally effective for pain control but seem to be associated with fewer complications and side-effects.

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Authors and Affiliations

  1. Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Deutschland

    A.W. Reske, A.P. Reske & V. Meier

  2. Anästhesieabteilung, ACQUA Klinik, Leipzig, Deutschland

    M. Wiegel

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  1. A.W. Reske
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  2. A.P. Reske
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  3. V. Meier
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  4. M. Wiegel
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Correspondence to A.W. Reske.

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Reske, A., Reske, A., Meier, V. et al. Periphere Nervenblockaden an der unteren Extremität. Anaesthesist 58, 1055–1072 (2009). https://doi.org/10.1007/s00101-009-1610-4

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