Klinische Ergebnisse nach „Enhanced-recovery“-Programmen

Clinical results after enhanced recovery programs

Zusammenfassung

„Enhanced-Recovery“-Programme („enhanced recovery after surgery“, ERAS) sind evidenzbasierte, interdisziplinär verfasste, patientenzentrierte Behandlungskonzepte mit dem Ziel der schnellstmöglichen Mobilisation der Patienten nach Knieendoprothese. Mit einer optimierten präoperativen Vorbereitung und Information der Patienten, einem optimierten multimodalen Schmerztherapiekonzept mit einer lokalen Infiltrationsanästhesie (LIA), minimal-invasiven Operationstechniken, der schnellstmöglichen Mobilisation nach der Operation und dem konsequenten Verzicht auf Drainagen, Blasenkatheter, Femoraliskatheter und der Blutsperre wurden viele Vorteile hinsichtlich des klinischen Ergebnisses publiziert. Patienten haben weniger Schmerzen, einen geringeren Blutverlust, eine geringere Gefahr, eine Bluttransfusion zu benötigen, eine bessere Beweglichkeit, eine bessere Kraft und Funktion und ein geringeres Risiko, eine Thrombose, Embolie oder andere Komplikation zu erleiden. Patienten schlafen besser und zeigen eine erhöhte Patientenzufriedenheit mit diesen Behandlungskonzepten im Vergleich zu bisherigen Behandlungsabläufen.

Abstract

Enhanced recovery after surgery (ERAS) is an evidence-based, patient centered team approach that aims for early mobilization and rapid recovery after knee arthroplasty. Therefore, optimized preoperative patient preparation and education as well as a multimodal pain concept including local infiltration anesthesia (LIA) and minimally invasive surgical techniques are necessary. ERAS renounces the use of drains, femoral nerve blocks, catheters and tourniquets. Patients treated with ERAS concepts have been shown to have less pain, reduced blood loss, lower transfusion rates, a better range of motion, a better functionality and a lower risk for thrombosis, embolism and other complications. Patients have reported sleeping better and having higher satisfaction compared to traditional treatment concepts.

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Correspondence to M. Clarius MD, PhD.

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Interessenkonflikt

M. Clarius ist Mitglied des European Advisory Boards „Rapid Recovery“ von Zimmer Biomet und hat für entsprechende Vortragstätigkeiten Honorare und Fahrtkostenerstattungen erhalten und bekommt Forschungsunterstützung von Zimmer Biomet. L.M. Clarius gibt 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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R. von Eisenhart-Rothe, München

R. Hube, München

W. Petersen, Berlin

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Clarius, M., Clarius, L.M. Klinische Ergebnisse nach „Enhanced-recovery“-Programmen. Knie J. 2, 27–30 (2020). https://doi.org/10.1007/s43205-019-00032-0

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Schlüsselwörter

  • Verbesserte postoperative Genesung
  • Knieendoprothetik
  • Perioperatives Management
  • Lokalanästhesie
  • Schmerzmanagement

Keywords

  • Enhanced postsurgical recovery
  • Knee arthroplasty
  • Perioperative management
  • Local anesthesia
  • Pain management