Xenonnarkosen – Klinische Besonderheiten, Vor- und Nachteile sowie mögliche Einsatzgebiete

Zusammenfassung

Das Edelgas Xenon kommt in der Summe seiner Eigenschaften dem „idealen Anästhetikum“ sehr nahe. Es gewährleistet eine hohe hämodynamische Stabilität und kurze Aufwachzeiten bei gleichzeitigem Fehlen relevanter Nebenwirkungen. Hauptnachteil ist sein hoher Preis. In tierexperimentellen Studien konnten zusätzlich spezifische organprotektive Effekte nachgewiesen werden, v.a. für Herz und Gehirn. Damit könnte Xenon bei Risikopatienten bzw. spezifischen Eingriffen möglicherweise Vorteile gegenüber anderen Anästhetika zeigen, die seine klinische Verwendung sinnvoll erscheinen lassen.

Abstract

The noble gas xenon provides many characteristics of the 'ideal anaesthetic agent'. Xenon offers outstanding haemodynamic stability and rapid emergence from anaesthesia without relevant side effects or toxity. The major limitation for its application in clinical routine is the high price. Recent studies demonstrated additional protective effects against ischaemic injury in particular for the heart and the brain. Therefore, xenon may be beneficial in a subset of high risk patients or operations and may become a meaningful alternative to other anaesthetics in this population.

Kernaussagen

• Xenon vereint viele Eigenschaften eines „idealen“ Anästhetikums, u. a. gewährleistet es hohe hämodynamische Stabilität und kurze Aufwachphasen.

• Zusätzliche spezifische kardioprotektive Effekte lassen Xenon v. a. für kardiovaskuläre Risikopatienten besonders geeignet erscheinen.

• Neuroprotektive Wirkungen des Xenons könnten zur Reduktion postoperativer neurokognitiver Defizite beitragen bzw. in Kombination mit Hypothermie zur Therapie bei zerebraler Ischämie Vorteile bieten.

• Klinisch relevante Vorteile des Xenons gegenüber anderen Anästhetika müssen in großen klinischen Studien weiter untersucht werden.

• Die Verwendung von Xenon erscheint derzeit nur bei speziellen Indikationen und Risikopatienten sinnvoll.

• Hohe Kosten sind die Hauptlimitation des Einsatzes von Xenon.

Schlüsselwörter:

Edelgas - Xenon - Anästhesie - Organprotektion - Risikopatienten

Key words:

noble gas - xenon - anaesthesia - organ protection - perioperative risk

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