Geschlechtsspezifische Unterschiede in der Anästhesiologie

Bei der anästhesiologischen Betreuung von Frauen sind aufgrund geschlechtsspezifischer Unterschiede zahlreiche Aspekte zu beachten: Neben hormonellen Unterschieden spielen die unterschiedliche Pharmakokinetik und -dynamik eine wesentliche Rolle bei der Anästhetika-Wirkung. Auch psychosoziale Aspekte sind zu berücksichtigen. Frauen haben ein erhöhtes Risiko für PONV und intraoperative Awareness, Männer dagegen ein erhöhtes Risiko für postoperatives Delir.

Abstract

Gender specific differences are a current and increasingly discussed topic. Cardiovascular conditions in women are often diagnosed later and with more advanced severity. Similarly, women are frequently underrepresented in studies investigating the effects of anesthetics on the central nervous system. In the field of anesthesiology, scientific interest in this topic has grown rapidly. Gender specific differences arise from anatomical, physiological, and psychosocial factors, all of which can significantly influence the perioperative and postoperative management. This highlights the importance of awareness and appropriately addressing these differences. The aim of this review article is to summarize the most relevant sex-specific differences in the field of anesthesiology.

Kernaussagen

• Bei der anästhesiologischen Betreuung von Patienten sollten geschlechtsspezifische physiologische Unterschiede berücksichtigt werden.

• Schon in der Prämedikationsambulanz sind geschlechtsspezifische Risikofaktoren bezüglich kardiovaskulärer und pulmonaler Pathologien zu erfassen.

• Das Blutvolumen und die Hämoglobinkonzentration sind bei Frauen geringer, was bei Blutverlusten zu einem höheren Transfusionsrisiko führt.

• Perioperativ können die Dosen der Anästhetika und Relaxanzien geschlechtsspezifisch angepasst werden. Hierbei helfen ein Narkosetiefe-Monitoring und eine Relaxometrie sowie das strikte Dosieren „nach Wirkung“.

• Postoperativ leiden Frauen häufiger an Schmerzen und Übelkeit, weshalb eine suffiziente Analgesie und PONV-Therapie besonders wichtig sind.

Schlüsselwörter

Anästhesiologie - geschlechtsspezifische Unterschiede - Obstruktives Schlafapnoe-Syndrom - OSAS - PNOV - postoperative Übelkeit und Erbrechen - postoperative Awareness - Hypnotika - Schwangerschaft - kardiovaskuläre Komorbiditäten

Keywords

postoperative nausea and vomitus - anesthesiology - gender specific differences - postoperative awareness

Publication History

Article published online:
08 January 2026

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