Skip to main content
SpringerLink
Log in

Perioperatives Vorgehen

  • Chapter
  • First Online:
NeuroIntensiv

  • 7119 Accesses

Zusammenfassung

Die Narkose bei neurochirurgischen Patienten stellt eine Besonderheit der anästhesiologischen Praxis dar, da das ZNS gleichzeitig Zielorgan der chirurgischen Therapie und der Anästhetika ist. Aus Anamnese und körperlicher Untersuchung ergeben sich Art und Umfang der weiteren präoperativen Diagnostik unter Berücksichtigung des OP-Risikos und der Dringlichkeit des geplanten Eingriffs. Weiterführende diagnostische Verfahren sollten individuell veranlasst werden, gehören jedoch nicht zum Routinescreening. Die postoperative Überwachung ist ein elementarer Bestandteil der Aufgaben der (neuro)chirurgischen Intensivmedizin. Nur so können Komplikationen rasch erkannt und adäquat therapiert werden. Besondere Aufmerksamkeit ist notwendig bei größeren intrakraniellen Eingriffen, bei Patienten mit erhöhtem Operations- und Narkoserisiko oder schweren kardialen oder pulmonalen Vorerkrankungen sowie bei unerwarteten intraoperativen Komplikationen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Literatur

Zu 24.1

  1. Archer C, Levy AR, McGregor (1993) Value of routine preoperative chest x-rays: A meta analysis. Can J Anaesth 40:1022–1027

    Article  CAS  PubMed  Google Scholar 

  2. Arozullah AM, Conde MV, Lawrence VA (2003) Preoperative evaluation for postoperative pulmonary complications. Med Clin North Am 87:153–173

    Article  PubMed  Google Scholar 

  3. Choi JH, Cho DK, Song YB et al (2010) Preoperative NT-proBNP and CRP predict perioperative major cardiovascular events in noncardiac surgery. Heart 96:56–62

    Article  CAS  PubMed  Google Scholar 

  4. Chung F, Yuan H, Yin L, Vairavanathan S, Wong DT (2009) Elimination of preoperative testing in ambulatory surgery. Anesth Analg 108:467–475

    Article  PubMed  Google Scholar 

  5. De Hert S, Imberger G, Carlisle J, Diemunsch P, Fritsch G, Moppett I, Task Force on Preoperative Evaluation of the Adult Noncardiac Surgery Patient of the European Society of Anaesthesiology (2011) Preoperative evaluation of the adult patient undergoing non-cardiac surgery: Guidelines from the European Society of Anaesthesiology. Europ J Anaesthesiol 28:684–722

    Article  Google Scholar 

  6. Dzankic S, Pastor D, Gonzalez C, Leung JM (2001) The prevalence and predictive value of abnormal preoperative laboratory tests in elderly surgical patients. Anesth Analg 93:301–308

    CAS  PubMed  Google Scholar 

  7. Eagle KA, Berger PB, Calkins H et al (2002) ACC/AHA Guideline Update for Perioperative Cardiovascular Evaluation for Noncardiac Surgery – Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Anesth Analg 94:1052–1064

    Article  PubMed  Google Scholar 

  8. Empfehlung des wissenschaftlichen Arbeitskreises Neuroanästhesie der DGAI (2008) Perioperatives Management bei neurochirurgischen Operationen in sitzender oder halbsitzender Position. Anästh Intensivmed 49: 47–51; www.dgai.de/06_1_00tabelle.htm

  9. Fleischmann KE, Beckman JA, Buller CE et al (2009) ACCF/AHA focused update on perioperative beta blockade. J Am Coll Cardiol 54:2102–2128

    Article  PubMed  Google Scholar 

  10. Fleisher LA, Beckman JA, Brown KA et al (2007) ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery. Circulation 116:1971–1996

    Article  PubMed  Google Scholar 

  11. Giebl A, Gürtler K (2014) Neue orale Antikoagulanzien in der perioperativen Medizin. Anaesthesist 63:347–362

    Article  CAS  PubMed  Google Scholar 

  12. Gogarten W et al (2010) Regional anaesthesia and antithrombotic agents: recommendations of the European Society of Anaesthesiology. Eur J Anaesthesiol 27:999–1015

    Article  CAS  PubMed  Google Scholar 

  13. Jambor C, Spannagl M, Zwissler B (2009) Perioperatives Management bei Patienten mit Koronarstents bei nichtherzchirurgischen Eingriffen. Anästhesist 58:971–985

    Article  CAS  Google Scholar 

  14. Kerwat KM, Kratz CD, Olt C, Christ M, Ziring M, Wulf H, Geldner G (2004) Marburg model for optimization of stratification of the anaesthesiological risk. Anaesthesist 53:856–861

    Article  CAS  PubMed  Google Scholar 

  15. Kühnl A, Dirrigl AM, Eckstein HH (2009) Extrakranielle Carotisstenose – wer soll gescreent werden? Gefässchirurgie 14:362–369

    Article  Google Scholar 

  16. Mantha S, Roizen MF, Madduri J, Rajender Y, Shanti Naidu K, Gayatri K (2005) Usefulness of routine preoperative testing: a prospective single-observer study. J Clin Anesth 17:51–57

    Article  PubMed  Google Scholar 

  17. Pfanner G, Koscielny J, Pernerstorfer T et al (2007) Präoperative Blutungsanamnese. Empfehlungen der Arbeitsgruppe perioperative Gerinnung der Österreichischen Gesellschaft für Anästhesiologie, Reanimation und Intensivmedizin. Anaesthesist 56:604–611

    Article  CAS  PubMed  Google Scholar 

  18. Poldermans D, Bax JJ, Boersma E et al (2009) Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: the Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA). Eur Heart J 30:2769–2812

    Article  PubMed  Google Scholar 

  19. Rohde LE, Polanczyk CA, Goldman L, Cook EF, Lee RT, Lee TH (2001) Usefulness of transthoracic echocardiography as a tool for risk stratification of patients undergoing major noncardiac surgery. Am J Cardiol 87:505–509

    Article  CAS  PubMed  Google Scholar 

  20. Schein OD, Katz J, Bass EB et al (2000) The value of routine pre-operative medical testing before cataract surgery. New Engl J Med 342:168–175

    Article  CAS  PubMed  Google Scholar 

  21. Schellong SM, Haas S (2012) Perioperative Thromboseprophylaxe – Neue orale Antikoagulantien und ihre Anwendung im Umfeld operativer Eingriffe. Anästhesiol Intensivmed Notfallmed Schmerzther 47:266–272

    PubMed  Google Scholar 

  22. Wappler F (2014) Empfehlungen zur präoperativen anästhesiologischen Evaluation. Anästh Intensivmed 55:110–124

    Google Scholar 

  23. Weber M, Luchner A, Manfred S et al (2013) Incremental value of high-sensitive trotonin T in addition to the revised cardiac index for peri-operative risk stratification in non-cardiac surgery. Eur Heart J 34:853–862

    Article  CAS  PubMed  Google Scholar 

  24. Zwissler B et al (2010) Präoperative Evaluation erwachsener Patienten vor elektiven, nicht kardiochirurgischen Eingriffen. Gemeinsame Empfehlung der DGAI, DGI, DGCH. Anästh Intensivmed 51:S788–S797

    Google Scholar 

Zu 24.2

  1. Agnelli G (2004) Prevention of venous thromboembolism in surgical patients. Circulation 110:IV4–12

    Article  PubMed  Google Scholar 

  2. Epstein NE (2005) A review of the risks and benefits of differing prophylaxis regimens for the treatment of deep venous thrombosis and pulmonary embolism in neurosurgery. Surg Neurol 64:295–301

    Article  PubMed  Google Scholar 

  3. Gerlach R, Raabe A, Scharrer I et al (2004) Post-operative hematoma after surgery for intracranial meningiomas: causes, avoidable risk factors and clinical outcome. Neurol Res 26:61–66

    Article  PubMed  Google Scholar 

  4. Gnaegi A, Feihl F, Perret C (1997) Intensive care physicians’ insufficient knowledge of right-heart catheterization at the bedside: time to act? Crit Care Med 25:213–220

    Article  CAS  PubMed  Google Scholar 

  5. Golembiewski J, Chernin E, Chopra T (2005) Prevention and treatment of postoperative nausea and vomiting. Am J Health Syst Pharm 62:1247–1260

    Article  CAS  PubMed  Google Scholar 

  6. Grumme T, Koudstaal PJ (1995) Kraniale, zerebrale und neuropädiatrische Chirurgie Komplikationen in der Neurochirurgie, Bd. 2. Blackwell Wissenschaftsverlag, Berlin Wien

    Google Scholar 

  7. Guidelines for the management of severe traumatic brain injury (2007) VI. Indications for intracranial pressure monitoring. J Neurotrauma 24 (Suppl 1): S37–S44

    Google Scholar 

  8. Kiening KL, Haux D, Steiner T et al (2006) Handbuch Intensivmedizin des Neurozentrums am Universitätsklinikum Heidelberg. Springer, Berlin Heidelberg New York

    Google Scholar 

  9. Lakkireddy D, Reddy YM, Di Biase L et al (2012) Feasibility and safety of dabigatran versus warfarin for periprocedural anticoagulation in patients undergoing radiofrequency ablation of atrial fibrillation: results from a multicenter prospective. J Am Coll Cardiol 59:1168–1174

    Article  CAS  PubMed  Google Scholar 

  10. Douketis J, Liew A (2013) Perioperative management of patients who are receiving a novel oral anticoagulant. Intern Emerg Med 8:477–484

    Article  PubMed  Google Scholar 

  11. Lu WY, Rhoney DH, Boling WB et al (1997) A review of stress ulcer prophylaxis in the neurosurgical intensive care unit. Neurosurgery 41:416–425

    Article  CAS  PubMed  Google Scholar 

  12. Palmer JD, Sparrow OC, Iannotti F (1994) Postoperative hematoma: a 5-year survey and identification of avoidable risk factors. Neurosurgery 35:1061–1064

    Article  CAS  PubMed  Google Scholar 

  13. Piek J, Unterberg A (1995) Grundlagen neurochirurgischer Intensivmedizin, 2. Aufl. Zuckschwerdt, München Bern Wien New York

    Google Scholar 

  14. Sakka SG, Klein M, Reinhart K et al (2002) Prognostic value of extravascular lung water in critically ill patients. Chest 122:2080–2086

    Article  PubMed  Google Scholar 

  15. Sandham JD, Hull RD, Brant RF et al (2003) A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med 348:5–14

    Article  PubMed  Google Scholar 

  16. Taylor WA, Thomas NW, Wellings JA et al (1995) Timing of postoperative intracranial hematoma development and implications for the best use of neurosurgical intensive care. J Neurosurg 82:48–50

    Article  CAS  PubMed  Google Scholar 

  17. Uchino S, Bellomo R, Morimatsu H et al (2006) Pulmonary artery catheter versus pulse contour analysis: a prospective epidemiological study. Crit Care 10:R174

    Article  PubMed  PubMed Central  Google Scholar 

  18. Warnick RE, Longmore LM, Paul CA et al (2003) Postoperative management of patients after stereotactic biopsy: results of a survey of the AANS/CNS section on tumors and a single institution study. J Neurooncol 62:289–296

    Article  PubMed  Google Scholar 

Internetadressen

Download references

Author information

Authors and Affiliations

  1. Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    Andreas Unterberg Prof. Dr.

  2. Abt. für Anästhesiologie, Intensiv-, Notfall- und Schmerzmedizin, Asklepios Klinik Nord - Heidberg, Tangstedter Landstraße 400, 22417, Hamburg, Deutschland

    Philipp Merkel Dr. & Oliver Detsch PD Dr.

  3. Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    Daniel Haux Dr.

Authors
  1. Philipp Merkel Dr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Oliver Detsch PD Dr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel Haux Dr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andreas Unterberg Prof. Dr.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Philipp Merkel Dr. .

Editor information

Editors and Affiliations

  1. Neurologische Klinik, Universitätklinikum Erlangen, Erlangen, Germany

    Stefan Schwab

  2. Neurologische Klinik und Geriatrie, Johannes Wesling Klinikum Minden, Minden, Germany

    Peter Schellinger

  3. Klinik für Anästhesiologie, Klinikum der Johannes-Gutenberg-Universität Mainz, Mainz, Germany

    Christian Werner

  4. Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany

    Andreas Unterberg

  5. Neurologische Klinik, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany

    Werner Hacke

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Merkel, P., Detsch, O., Haux, D., Unterberg, A. (2015). Perioperatives Vorgehen. In: Schwab, S., Schellinger, P., Werner, C., Unterberg, A., Hacke, W. (eds) NeuroIntensiv. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46500-4_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-46500-4_24

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-46499-1

  • Online ISBN: 978-3-662-46500-4

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation