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Schmerztherapie und anästhesiologisches Vorgehen in der Fast-Track-Endoprothetik

Pain therapy and anaesthesiological procedures in fast-track arthroplasty

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Zusammenfassung

Seit Einführung der Fast-Track-Chirurgie in der Endoprothetik stellt sich für alle beteiligten Disziplinen die Aufgabe einer engen und kontinuierlichen gemeinsamen Kommunikation im Rahmen der täglichen Routineversorgung. Interdisziplinär vereinbarte Prozesse müssen in regelmäßigen Abständen überprüft, gegebenenfalls angepasst und neu ausgerichtet werden, mit dem Ziel die perioperativen Risiken sowohl medizinisch als auch entlang des Behandlungspfades zu optimieren. Die Verantwortlichkeit des Anästhesisten beschränkt sich hierbei nicht nur auf die Durchführung der Anästhesie, sondern umfasst die Versorgung der Patienten mit dem Blick auf eine optimale Schmerztherapie, den Erhalt der Homöostase und die Sicherstellung einer schnellen Rückkehr der patienteneigenen Selbstbestimmung.

Abstract

Since the introduction of fast-track surgery in the field of arthroplasty, all disciplines involved have been challenged with the task of close and continuous joint communication in the context of daily routine care. Processes that have been agreed upon interdisciplinarily must be reviewed at regular intervals, and, if necessary, adapted and newly agreed upon with the aim of optimizing the perioperative risks both medically and along the therapeutic pathway. The responsibility of the anaesthesiologist is not only limited to the performance of anaesthesia, but also includes the care of patients with a view to optimal pain therapy, maintenance of homeostasis and ensuring a rapid return of the patient’s self-determination.

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Abbreviations

5‑HT3:

5‑Hydroxytryptamin

ASA :

American Society of Anesthesiologists

DGAI :

Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin

GFR :

Glomeruläre Filtrationsrate

IBW :

„Ideal body weight“

KG :

Körpergewicht

LIA :

Infiltrationsanalgesie

NRS :

Numerische Rating-Skala

NuDESC :

Nursing Delirium Screening Scale

PBM :

Patient-Blood-Management-Konzept

PCA :

„Patient-controlled analgesia“

PONV :

„Postoperative nausea and vomiting“

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Authors and Affiliations

  1. Klinik für Anästhesiologie und Interdisziplinäre Intensivmedizin, Evangelisches Waldkrankenhaus Spandau, Stadtrandstraße 555, 13589, Berlin, Deutschland

    Fabian Tetzner, Sabine Schlüter-Albrecht & Stephan-Matthias Reyle-Hahn

  2. Klinik für Orthopädie und Unfallchirurgie, Evangelisches Waldkrankenhaus Spandau, Berlin, Deutschland

    Lars Rackwitz & Ulrich Nöth

  3. Klinik für Orthopädie, Orthopädische Chirurgie und Unfallchirurgie, Vulpius Klinik, Bad Rappenau, Deutschland

    Michael Clarius

Authors
  1. Fabian Tetzner
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  2. Sabine Schlüter-Albrecht
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  3. Lars Rackwitz
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  4. Michael Clarius
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  5. Ulrich Nöth
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  6. Stephan-Matthias Reyle-Hahn
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Corresponding author

Correspondence to Stephan-Matthias Reyle-Hahn.

Ethics declarations

Interessenkonflikt

F. Tetzner, S. Schlüter-Albrecht, L. Rackwitz, M. Clarius, U. Nöth und S.-M. Reyle-Hahn geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Tetzner, F., Schlüter-Albrecht, S., Rackwitz, L. et al. Schmerztherapie und anästhesiologisches Vorgehen in der Fast-Track-Endoprothetik. Orthopäde 51, 358–365 (2022). https://doi.org/10.1007/s00132-022-04248-3

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