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Skoliosechirurgie bei Kindern aus anästhesiologischer Sicht

Scoliosis surgery in children from the viewpoint of anaesthesiology

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Zusammenfassung

Skoliosechirurgie im Kindesalter ist eine Herausforderung für den Kinderanästhesisten: Die Invasivität des Eingriffs bei einem inhomogenen Patientenkollektiv verschiedenster Größe, Gewicht und zugrunde liegender Pathologie stellt besondere Anforderungen an Monitoring, Narkoseführung, Lagerung des Patienten, Blutersatzverfahren, altersspezifischer (Patho)physiologie, Ventilation und postoperative Schmerztherapie. Die Einführung von Monitoringverfahren der Rückenmarkfunktionen erfordert eine Anpassung der Narkoseverfahren, sodass auch die Anästhesie einer permanenten Weiterentwicklung aufgeschlossen bleiben muss, deren aktuelle Konzepte in dieser Übersichtsarbeit besprochen werden.

Abstract

Anaesthesia for scoliosis surgery in children is a challenge for the paediatric anaesthesiologist. The large range of underlying pathologies causing deranged physiology in an inhomogeneous patient group ranging from neonates to adolescents necessitates diligent and individual preparation for each case. Due to the invasiveness of the operation demanding anaesthetic care is necessary. This review highlights current approaches to monitoring, anaesthetic regimen, positioning of the patient, blood conservation and transfusion, age-related pathophysiology, ventilation and postoperative pain therapy. The introduction of neurophysiologic spinal cord monitoring requires certain adaptations of the anaesthetic regimen to suit technological advances.

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Authors and Affiliations

  1. Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinik, Münster, Deutschland

    M. Wenk & D.M. Pöpping

  2. Klinik für Anästhesiologie und operative Intensivmedizin, St. Franziskus Hospital, Hohenzollernring 72, 48145, Münster, Deutschland

    D. Jockenhöfer &  M. Möllmann

  3. Abteilung für Orthopädie II –Wirbelsäulenchirurgie-, St. Franziskus Hospital, Münster, Deutschland

    U. Liljenqvist

Authors
  1. M. Wenk
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  2. D. Jockenhöfer
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  3. D.M. Pöpping
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  4. U. Liljenqvist
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  5. M. Möllmann
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Corresponding author

Correspondence to M. Möllmann.

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Wenk, M., Jockenhöfer, D., Pöpping, D. et al. Skoliosechirurgie bei Kindern aus anästhesiologischer Sicht. Orthopäde 38, 170–175 (2009). https://doi.org/10.1007/s00132-008-1361-y

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  • DOI: https://doi.org/10.1007/s00132-008-1361-y

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