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Neurodestruktive Verfahren in der Schmerztherapie pp 233–241Cite as

Chemische Neurolyse beim ischämischen Schmerz

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Zusammenfassung

Durch Sympathektomien lassen sich Ischämieschmerzen lindern und beseitigen. Die Bedeutung der Sympathektomie bei der Behandlung von Durchblutungsstörungen hat jedoch seit den 6oer Jahren erheblich abgenommen. Der Grund hierfür ist sicherlich die Weiterentwicklung und der zunehmende Einsatz der interventionellen radiologischen Maßnahmen und der chirurgischen Revaskularisierung [2, 43], zum anderen war die chirurgische Sympathektomie mit einer vergleichsweise hohen Mortalität verbunden [25]. Die perkutane chemische Sympathikusneurolyse mit Phenol oder Ethanol vermied das Operationstrauma und führte zu einer Senkung der Mortalität [10]. Die Ergebnisse sind einer offenen Sympathektomie vergleichbar, sodass sich die perkutane Technik als das Verfahren der ersten Wahl weitgehend durchsetzte [16, 36]. Perkutane, chemische Neurolysen des zervikalen oder thorakalen Grenzstranges sind wegen der engen Nachbarschaft zu Halseingeweiden und Pleura risikoreich und nicht indiziert.

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Authors
  1. M. Gleim
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Editors and Affiliations

  1. Klinik für Anästhesiologie, Intensiv- und Schmerztherapie, Evangelisches Johannes-Krankenhaus, Schildescher Straße 99, 33611, Bielefeld, Germany

    Ulrich B. Hankemeier

  2. Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin Schwerpunkt Algesiologie, Universität Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany

    Jan Hildebrandt

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Gleim, M. (2002). Chemische Neurolyse beim ischämischen Schmerz. In: Hankemeier, U.B., Hildebrandt, J. (eds) Neurodestruktive Verfahren in der Schmerztherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59376-5_17

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  • DOI: https://doi.org/10.1007/978-3-642-59376-5_17

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-41922-8

  • Online ISBN: 978-3-642-59376-5

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