Zusammenfassung
Die Prävention und Therapie postoperativer Schmerzen, Übelkeit und Erbrechen nach laparoskopischen Eingriffen in der Gynäkologie stellt für alle Beteiligten immer wieder eine Herausforderung dar. Als potenzielle Risikofaktoren sind heute präoperative Unterleibsschmerzen, bestimmte Genvarianten und der mentale Zustand der Patientinnen bekannt. Zur Prävention von Schulterschmerzen kommen Drainagen, pulmonale Rekrutierungsmanöver, Pregabalin und aktives Absaugen des Kapnoperitoneums zum Einsatz. Zur Vorbeugung und Therapie von Übelkeit und Erbrechen haben sich 5‑HT3-Antagonisten auch in Kombination mit Dexamethason oder Aprepitant sowie alternative Heilmethoden wie Elektroakupunktur bewährt.
Abstract
The prevention and treatment of postoperative pain, nausea and vomiting after laparoscopic interventions in gynecology is always a challenge for all participants. Nowadays, potential risk factors are known to include preoperative lower abdominal pain, certain gene variants and the mental state of the patients. For the prevention of shoulder pain, drainage, pulmonary recruitment maneuvers, pregabalin and active aspiration of the capnoperitoneum are used. For the prevention and treatment of nausea and vomiting, 5‑HT3 antagonists are used in combination with dexamethasone or aprepitant. Finally, alternative methods such as electroacupuncture have shown initial success.
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T. Fehm, Düsseldorf
L. Kiesel, Münster
R. Kimmig, Essen
N. Maass, Kiel
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Simon, A. Update Laparoskopie: postoperative Analgesie und Prävention von Nausea und Vomitus. Gynäkologe 52, 617–621 (2019). https://doi.org/10.1007/s00129-019-4429-3
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DOI: https://doi.org/10.1007/s00129-019-4429-3