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2011 | OriginalPaper | Buchkapitel

25. Spezielle Aspekte der anästhesiologischen Pharmakotherapie

verfasst von : Prof. Dr. Peter H. Tonner, Dr. Gerald Bandemer

Erschienen in: Pharmakotherapie in der Anästhesie und Intensivmedizin

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Der derzeitige Kenntnisstand zur Prophylaxe und Therapie ischämischer Schäden des Gehirns beruht im Wesentlichen auf Ergebnissen aus Tierversuchen. Ischämien im Gehirn verursachen eine Reihe von Prozessen, die zum Zelluntergang führen. Dazu gehören neben vielen anderen die Freisetzung exzitatorischer Transmitter, die verzögerte neuronale Nekrose, die selektive Vulnerabilität, Apoptose, die ischämische Penumbra, die Schädigung durch freie Radikale, die verzögerte Hypoperfusion, pharmakologische Effekte von Anästhetika auf den zerebralen Blutfluss sowie den Zellmetabolismus. Aus klinischen Untersuchungen ist bekannt, dass Patienten, die sich einem chirurgischen Eingriff unterziehen müssen gegenüber nichthospitalisierten Patienten eine leicht erhöhte Schlaganfallshäufigkeit aufweisen. Allerdings stellt die perioperative Phase eine hochkomplexe Situation dar, in der sich kausale Effekte von Schädigung, Prävention und Therapie nicht immer leicht herausarbeiten lassen. Dies liegt nicht zuletzt daran, dass die Patienten anästhesiert sind, also auf der einen Seite potenziell geschützt sind vor ischämischen Schäden, auf der anderen Seite aber keine frühzeitige neurologische Diagnostik erlauben, die am wachen Patienten möglich ist. Dementsprechend können nur wenige klare und gut belegte Aussagen zur zerebralen Protektion getroffen werden.

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Titel: Spezielle Aspekte der anästhesiologischen Pharmakotherapie
verfasst von: Prof. Dr. Peter H. Tonner
Dr. Gerald Bandemer
Verlag: Springer Berlin Heidelberg
Buch: Pharmakotherapie in der Anästhesie und Intensivmedizin
Print ISBN: 978-3-540-79155-3

Electronic ISBN: 978-3-540-79156-0

Copyright-Jahr: 2011
DOI: https://doi.org/10.1007/978-3-540-79156-0_25

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25. Spezielle Aspekte der anästhesiologischen Pharmakotherapie

Zusammenfassung

Neu im Fachgebiet AINS

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Hinter dieser Appendizitis steckte ein Erreger

Ärztliche Empathie hilft gegen Rückenschmerzen

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

Update AINS

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Neu im Fachgebiet AINS

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Hinter dieser Appendizitis steckte ein Erreger

Ärztliche Empathie hilft gegen Rückenschmerzen

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

Update AINS