Zusammenfassung
Trotz der großen Zahl i.v.-Drogenabhängiger sind die anästhesiologischen Konzepte zur Behandlung von heroinabhängigen Patienten unklar, um ein akutes Entzugssyndrom oder den Rückfall zur Sucht zu vermeiden. Wir berichten über eine 24-jährige Patientin, die sich 11 Monate nach erfolgreichem Heroinentzug einem elektiven Trikuspidalklappenersatz unterziehen musste. Der Eingriff wurde in thorakaler Periduralanästhesie, balancierter Allgemeinanästhesie (Remifentanil, Desfluran/Propofol) und unter kontinuierlicher Clonidininfusion komplikationslos durchgeführt.
Abstract
A 24-year-old female with a history of former heroin addiction underwent open heart surgery for a mechanical tricuspid valve replacement. Anaesthesiological management included a thoracic epidural catheter at the Th2/Th3 segments and balanced general anaesthesia (remifentanil, desflurane/propofol). Additionally, clonidine (2 µg*kg−1*h−1) was continuously administered. Pain therapy was achieved using 0.375% ropivacaine via a thoracic epidural catheter (4 ml*h−1) and metamizole (4×1 g/day) intravenously. With this concept we were able to achieve an appropriate anaesthesia and analgesia and the operation was carried out without complications.
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Kozian, A., Schilling, T., Tiede, T. et al. Trikuspidalklappenersatz bei einer heroinabhängigen Patientin. Anaesthesist 54, 578–581 (2005). https://doi.org/10.1007/s00101-005-0834-1
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DOI: https://doi.org/10.1007/s00101-005-0834-1