Zusammenfassung.
Obwohl in den letzten Jahren das Wissen über die Exkretion von Medikamenten in die
Muttermilch erheblich zugenommen hat, sind die Informationen über viele anästhesierelevante
Medikamente weiterhin lückenhaft. Insbesondere die Kenntnis über mögliche unerwünschte
Wirkungen auf den Säugling ist unzureichend. In dieser Arbeit erfolgt nach einer Beschreibung
der pharmakokinetischen Prinzipien des Medikamentenübertritts in die Muttermilch eine
detaillierte Darstellung des derzeitigen Wissenstandes für perioperativ gebräuchliche
Medikamente. Eine Narkose ist kein obligater Grund abzustillen. Denn es ist möglich,
eine Anästhesie bei einer stillenden Mutter durchzuführen, ohne auf die Vorzüge der
Muttermilchernährung verzichten zu müssen. Bei sorgfältiger Auswahl der Medikamente
müssen auch elektive chirurgische Eingriffe nicht verschoben werden, und das Stillen
kann in der unmittelbaren postoperativen Periode wiederaufgenommen werden.
Anaesthesia During Breast Feeding - Which Restrictions are Justified.
In the Iast years knowledge of the excretion of drugs into breast milk has increased
significantly. But information concerning anesthetic and analgesic drugs seems to
be dispersed and limited. This paper describes the pharmacokinetic principles of drug
transfer to milk and offers a comprehensive survey for drugs used in the perianesthetic
period. The necessity of anesthesia should never be a sufficient reason to quit breast-feeding.
With the information given in this article the individual duration of breast-milk-free
interval can be discussed. Thus it will be possible to anesthetize a breast-feeding
mother with minimal risks for the child without giving up the advantages of mother
milk. Through careful selection of appropriate drugs even elective operations don't
need to be postponed and breastfeeding can be continued as soon as in the immediate
postoperative period.
Schlüsselwörter:
Anästhesie - Narkose - Muttermilch - Stillen - Kolostrum - Säugling - Laktation
Key words:
Anesthesia - Breast-feeding - Breast milk - Colostrum - Infant - Lactation
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Dr. Peter Schneider
Klinik für Anaesthesiologie, op. Intensivmedizin, Schmerztherapie Klinikum Kreis
Herford
Schwarzenmoorstraße 70 32049 Herford