Anästhesie und Multiple Sklerose - Was gilt es zu beachten?

Zusammenfassung

Patienten mit seltenen neurologischen Erkrankungen sind stets eine Herausforderung im klinisch-operativen Alltag. Insbesondere anästhesiologische Interventionen können dabei mit vielfältigen Problemen behaftet sein. Der Artikel befasst sich mit dem aktuellen Wissensstand zur Multiplen Sklerose in der Anästhesie. Dabei beziehen sich die Autoren auf die sichere Vorbereitung und Durchführung verschiedener Anästhesieformen sowie die Vermeidung und ggfs. die Therapie möglicher Komplikationen.

Abstract

Patients with rare neurological diseases are always a challenge in routine clinical activity. In particular, anesthetic interventions can be fraught with many problems. This article deals with the current state of knowledge on multiple sclerosis in anesthesia. Here, the authors refer to the safe preparation for and implementation of various forms of anesthesia as well as the prevention and if necessary, treatment of possible complications.

Kernaussagen

• Patienten mit Multipler Sklerose können Allgemein- und Regionalanästhesien erhalten.

• Eingriffe sollten wenn möglich im akuten Schub vermieden werden.

• Eine erweiterte präoperative Evaluation ist erforderlich.

• Benzodiazepine sollten präoperativ möglichst vermieden werden.

• Succinylcholin ist als Muskelrelaxanz nicht empfehlenswert.

• Peridural- und Spinalanästhesien sind möglich unter Einsatz niedrig dosierter Lokalanästhetika ohne Epinephrinzusatz.

• Periphere Nervenblockaden sollten unter Ultraschallkontrolle durchgeführt werden.

• Multiple Sklerose bedarf häufig einer Arzneimitteltherapie, die im anästhesiologischen Kontext zu Problemen führen kann.

Schlüsselwörter:

Multiple Sklerose - Stufentherapie - Anästhesie - neurologische Erkrankung

Keywords:

mutiple sclerosis - anesthesia - neurological diseases - step-by-step therapy

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