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Indikation zur chirurgischen Sympathektomie bei chronischen Schmerzen

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Neurodestruktive Verfahren in der Schmerztherapie

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Zusammenfassung

Es besteht heute weitgehender Konsens, dass neurodestruktive Maßnahmen im allgemeinen, aber auch solche, bei denen sympathische Fasern zerstört werden, für die Therapie chronischer Schmerzen nur noch selten indiziert sind [12]. Hauptgrund hierfür ist die Effizienz weniger invasiver Methoden sowie die zwar seltenen, dann jedoch oftmals gravierenden Komplikationen bei neurodestruktiven Verfahren. Einige Nachteile und Nebenwirkungen, wie ein Postsympathektomiesyndrom, treten erst mit Latenz auf. Sie können daher bei Tumorschmerzen teilweise vernachlässigt werden, falls die Lebenserwartung begrenzt ist. Aus dem gleichen Grund ist auch nur bei Patienten mit chronischen Schmerzen anderer Genese der Umstand von Bedeutung, dass die Inzidenz eines Schmerzrezidivs vergleichsweise hoch ist, da es im Verlaufe von Monaten oder Jahren zur Reinnervation der sympathischen Zielorgane kommen kann.

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Authors
  1. C. Maier
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  2. M. Gleim
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  3. R. Baron
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Editors and Affiliations

  1. Klinik für Anästhesiologie, Intensiv- und Schmerztherapie, Evangelisches Johannes-Krankenhaus, Schildescher Straße 99, 33611, Bielefeld, Germany

    Ulrich B. Hankemeier

  2. Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin Schwerpunkt Algesiologie, Universität Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany

    Jan Hildebrandt

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© 2002 Springer-Verlag Berlin Heidelberg

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Maier, C., Gleim, M., Baron, R. (2002). Indikation zur chirurgischen Sympathektomie bei chronischen Schmerzen. In: Hankemeier, U.B., Hildebrandt, J. (eds) Neurodestruktive Verfahren in der Schmerztherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59376-5_18

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  • DOI: https://doi.org/10.1007/978-3-642-59376-5_18

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-41922-8

  • Online ISBN: 978-3-642-59376-5

  • eBook Packages: Springer Book Archive

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