Neue Ansätze in der perioperativen Algesimetrie

Die Messung der Narkosetiefe und Muskelrelaxation sind seit Jahren etablierte Routineverfahren während einer Allgemeinanästhesie. Eine Quantifizierung intraoperativer Nozizeption ist dagegen noch immer weitgehend unmöglich, und die Routineanwendung aller bisher erhältlichen Methoden ist nicht unproblematisch. Dieser Artikel erklärt methodologische Gemeinsamkeiten, aber auch spezifische Aspekte verschiedener kommerzieller Lösungsvorschläge zur perioperativen Algesimetrie.

Abstract

The measurement of anaesthetic depth and muscle relaxation have been routine procedures during general anaesthesia for years. Quantification of intraoperative nociception, on the other hand, is still largely impossible. Various methods have been tested and commercialised for more than 10 years. However, a real breakthrough has not yet been achieved and the routine application of all methods available so far is not without problems. This article explains methodological similarities, but also points to specific aspects of various commercial solutions for perioperative algesimetry.

Kernaussagen

• Blutdruck und Herzfrequenz sind oft nicht hinreichend in der Lage, perioperative Schmerzen eindeutig widerzuspiegeln. Diese Surrogatparameter sind zur Algesimetrie relativ ungeeignet.

• Perioperative Algesimetrie beruht oft auf der Messung einer hypothetischen, nozizeptionsbedingten physiologischen Stressantwort.

• Nahezu alle erhältlichen Monitore können intraoperative Schmerzreize abbilden – teilweise besser als Blutdruck und Herzfrequenz.

• Intraoperative Algesimetrie kann möglicherweise den Opioidverbrauch während einer Narkose senken.

• Der klinische Outcome-Vorteil intraoperativer Algesimetrie ist allerdings nicht unumstritten und bedarf weiterer Untersuchungen.

Schlüsselwörter

intraoperative Nozizeption - Schmerzmessung - Schmerzwahrnehmung - Analgesie

Keywords

intraoperative nociception - pain measuring - pain perception - analgesia

Publication History

Article published online:
06 December 2023

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