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Die Anaesthesiologie

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01.03.2004 | Schmerztherapie

Nichtopioidanalgetika zur perioperativen Schmerztherapie

Risiken und rationale Grundlagen für den Einsatz bei Erwachsenen

verfasst von: Dr. A. Brack, H. L. Rittner, M. Schäfer

Erschienen in: Die Anaesthesiologie | Ausgabe 3/2004

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Zusammenfassung

Nichtopioidanalgetika sind wesentlicher Bestandteil der perioperativen Schmerztherapie. In dieser Arbeit werden pharmakologische Aspekte, analgetische Wirksamkeit und unerwünschte Arzneimittelwirkungen der Nichtopioidanalgetika dargestellt. Im ersten Teil wird die Pharmakologie der Substanzen Diclofenac und Acetylsalicylsäure als saure und Metamizol, Paracetamol und die COX-2-Inhibitoren als nichtsaure antiphlogistische Analgetika beschrieben. Im zweiten Teil wird die analgetische Wirksamkeit der Nichtopioidanalgetika bei geringgradigen (z. B. ambulante Eingriffe) sowie als Kombinationstherapie mit Opioiden bei höhergradigen Schmerzen (z. B. Abdominalchirurgie) diskutiert. Der mögliche Nutzen einer Kombinationstherapie aus 2 Nichtopioidanalgetika wird dargestellt. Im dritten Teil werden die unerwünschten Arzneimittelwirkungen anhand Pathophysiologie, Häufigkeit und klinischer Relevanz beschrieben. Schwerpunkte sind die Wirkungen auf den Gastrointestinaltrakt (Ulkusbildung), die Blutgerinnung (Blutungsrisiko und Thromboseentstehung), das renale (Niereninsuffizienz), das pulmonale (Bronchospasmus) und das blutbildende System (Agranulozytose). Abschließend werden Empfehlungen zum klinischen Einsatz der Nichtopioidanalgetika in der postoperativen Schmerztherapie gegeben.

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Titel: Nichtopioidanalgetika zur perioperativen Schmerztherapie
Risiken und rationale Grundlagen für den Einsatz bei Erwachsenen
verfasst von: Dr. A. Brack
H. L. Rittner
M. Schäfer
Publikationsdatum: 01.03.2004
Verlag: Springer-Verlag
Erschienen in: Die Anaesthesiologie / Ausgabe 3/2004
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI: https://doi.org/10.1007/s00101-003-0641-5

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Springer Medizin

Nichtopioidanalgetika zur perioperativen Schmerztherapie

Risiken und rationale Grundlagen für den Einsatz bei Erwachsenen

Zusammenfassung

Neu im Fachgebiet AINS

Hinter dieser Appendizitis steckte ein Erreger

Ärztliche Empathie hilft gegen Rückenschmerzen

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

S3-Leitlinie zu Pankreaskrebs aktualisiert

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Springer Medizin

Zusammenfassung

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