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Neue und evidenzbasierte Aspekte in der postoperativen Schmerztherapie

New and evidence-based aspects of postoperative pain therapy

  • Leitthema
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Zusammenfassung

Die postoperative Akutschmerztherapie ist ein wichtiges Thema für die tägliche Praxis in der Unfallchirurgie und Orthopädie. Umfragen gehen davon aus, dass höchstens in etwa der Hälfte der Kliniken interdisziplinäre Konzepte vorhanden sind oder Schmerzen regulär gemessen und dokumentiert werden. Eine Verbesserung der Akutschmerztherapie kann in den zunehmend konkurrierenden Einrichtungen des Gesundheitsmarktes nicht nur einen Wettbewerbsvorteil darstellen, es kann unter den Zwängen der Verweildauerreduktion erlösrelevant werden. Daher lohnt es sich, evidenzbasierte Verfahren im Alltag gemeinsam umzusetzen.

Abstract

Poorly managed postoperative pain has been recognised to delay patient recovery and hospital discharge. Recent metaanalyses support a multimodal approach with combinations of analgesics from different classes. The pharmacological options of commonly used opioids, nonsteroidal anti-inflammatory drugs, and other nonopioid analgesics in combination have been shown to provide effective pain relief and to reduce opioid consumption. Local, intraarticular, epidural, and, more importantly, modern peripheral regional techniques can be used successfully to enhance perioperative analgesia. The use of continuous perineural techniques with local anaesthetic infusion has been extended beyond hospital discharge in many European countries.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Der Autor hat Referentenhonorare und Studienunterstützung der Firmen Abbott, Janssen Cilag, Arrow, Lilly, Astra Zeneca, Mundipharma, Baxter, Pharmacia & Upjohn, Pfizer und Glaxo Smith Kline erhalten. Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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  1. Universitätsklinik für Anästhesiologie und Operative Intensivmedizin, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum und Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    T. Volk

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Volk, T. Neue und evidenzbasierte Aspekte in der postoperativen Schmerztherapie. Orthopäde 37, 953–958 (2008). https://doi.org/10.1007/s00132-008-1331-4

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