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Die Orthopädie
Erschienen in: Die Orthopädie 10/2008

01.10.2008 | Leitthema

Schmerztherapie an den unteren Extremitäten

verfasst von: Dr. C.J.P. Simanski

Erschienen in: Die Orthopädie | Ausgabe 10/2008

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Zusammenfassung

Der Schmerztherapie nach Eingriffen an der unteren Extremität kommt eine entscheidende Bedeutung zu, sind die Patienten bei insuffizienter Analgesie doch wesentlich in ihrer Mobilität und Rekonvaleszenz eingeschränkt.
Wenn möglich sollen regionalanästhesiologische und rückenmarknahe Verfahren zur prä-, intra- und postoperativen Analgesie angewendet werden. Präoperativ systemisch sollten zusätzlich keine Analgetika verabreicht werden, wenngleich postoperativ Nichtopioide sowie Opioide empfohlen werden. Suffizient durch den operativ Tätigen durchführbare Schmerztherapiemaßnahmen sind die intraartikuläre Gabe von Lokalanästhetika allein oder in Kombination mit einem Opioid sowie physikalische (z. B. Kühlung) und physiotherapeutische Maßnahmen bei gelenknahen Eingriffen. Es gibt keine wissenschaftliche Rationale als Argument für die Einlage von Drainagen, die Wahl des Zugangsweges ist hingegen nicht abhängig zu machen vom Endpunkt Schmerz, sondern von individuellen anatomischen Patienteneigenschaften.
Wenngleich die lokoregionären Analgesieverfahren im direkten Vergleich wirksamer sind als die Systemischen, stehen dem operativ Tätigen selbst auch effiziente Verfahren zur Reduktion des postoperativen Schmerzes nach Eingriffen an der unteren Extremität zur Verfügung.
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Metadaten
Titel
Schmerztherapie an den unteren Extremitäten
verfasst von
Dr. C.J.P. Simanski
Publikationsdatum
01.10.2008
Verlag
Springer-Verlag
Erschienen in
Die Orthopädie / Ausgabe 10/2008
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI
https://doi.org/10.1007/s00132-008-1337-y

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