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01.03.2006 | Leitthema

Das Long-QT-Syndrom in der Anästhesie

verfasst von: Dr. S. Rasche, T. Koch, M. Hübler

Erschienen in: Die Anaesthesiologie | Ausgabe 3/2006

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Zusammenfassung

Das Long-QT-Syndrom (LQTS) ist eine seltene, angeborene oder erworbene Erkrankung mit einer Prädisposition zu malignen Herzrhythmusstörungen (Torsade de pointes, TdP). Ursächlich liegen den verschiedenen LQTS-Formen Störungen der kardialen Ionenkanäle zugrunde. Die Diagnostik erfolgt durch klinische, anamnestische und elektrographische Daten. Die möglichen Trigger einer TdP sind zahlreich und müssen in der perioperativen Phase vermieden werden. Eine vegetative Abschirmung der Patienten und eine Korrektur von Elektrolytstörungen sind essentiell. Volatile Anästhetika und eine Antagonisierung von Muskelrelaxanzien sollten vermieden, Lokalanästhetika in hohen Dosierungen können nicht empfohlen werden. Propofol ist zur Einleitung und zur Aufrechterhaltung einer Allgemeinanästhesie geeignet. Die Akuttherapie von TdPs mit hämodynamischer Instabilität orientiert sich an den Leitlinien des „advanced cardiac life support“ und umfasst Kardioversion/Defribrillation und die Gabe von Magnesium. Die Unterscheidung in bradykardie- und tachykardieassoziierte TdPs ist insbesondere bei der Langzeittherapie wichtig.

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Titel: Das Long-QT-Syndrom in der Anästhesie
verfasst von: Dr. S. Rasche
T. Koch
M. Hübler
Publikationsdatum: 01.03.2006
Verlag: Springer-Verlag
Erschienen in: Die Anaesthesiologie / Ausgabe 3/2006
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI: https://doi.org/10.1007/s00101-006-0981-z

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