Zusammenfassung
Die spinale und epidurale Anästhesie wird sehr häufig eingesetzt. Insbesondere die
steigende Anzahl ambulanter operativer Eingriffe wird diese Anästhesieform weiter
zunehmen lassen. Die spinale und epidurale Anästhesie ist als sicheres Verfahren zu
beurteilen, jedoch entstehen in seltenen Fällen Komplikationen, die in Einzelfällen
sehr schwerwiegend sein können. Zu unterscheiden sind systemische, traumatische, entzündliche,
vaskuläre und toxische Komplikationen. Die Komplikationen können passagerer Natur
sein oder bleibende Schäden hinterlassen. Im Einzelnen werden in unterschiedlicher
Häufigkeit folgende Komplikationen beobachtet: Herz-Kreislauf-Stillstand, epileptische
Anfälle, Kopfschmerzen, subdurale Hämatome, epidurale Blutungen, radikuläre Schmerzen
oder Ausfälle, Meningitiden, Diszitiden, spinale Infarkte, Luftembolien und toxische
Komplikationen. Die Kenntnis der Komplikationen der Spinal- und Epiduralanästhesie
ist in der postoperativen (Notfall-)Situation, bei der prognostischen Einschätzung
und bei Begutachtungen von Bedeutung.
Abstract
Spinal and epidural anaesthesia is frequently administered. Particularly increasing
ambulatory treatment leads to the increase of these interventions. Normally it is
a reliable and frequent intervention. Complications are rare but sometimes severe.
Complications may be transient or lasting. It is useful to distinguish between systemic
events such as cardiac arrest or epileptic seizures and more localized events like
headache, subdural or epidural haemorrhage, radiculopathies, meningitis, discitis,
air embolism and toxic complications regarding the spinal cord and the cauda equina.
The knowledge of these complications is fundamental. Especially in a postoperative
case of emergency to predict the outcome and to estimate the damage possibly caused
by this medical intervention.
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Dr. med. Hartmut Bauer
Klinikum der Stadt Ludwigshafen gGmbH · Akademisches Lehrkrankenhaus der Johannes-Gutenberg-Universität
Mainz · Neurologische Klinik
Bremserstraße 79
67063 Ludwigshafen
Email: bauerh@klilu.de