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Praktische Anwendung von Opiaten bei Neugeborenen

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Anästhesie bei Früh- und Neugeborenen

Part of the book series: Kinderanästhesie ((KINDERANAESTHES))

Zusammenfassung

Über lange Zeit bis in die jüngste Vergangenheit wurde die Applikation von Medikamenten zur Analgesie und Sedierung bei Neugeborenen sehr restriktiv gehandhabt [28]. Dafür sind zwei Hauptgründe zu nennen:

  • Neugeborene, bei denen der Einsatz von Analgetika und Sedativa überhaupt erwogen wird, bedürfen einer operativen Therapie und/oder neonatologischer Intensivpflege und sind meist kritisch krank.

  • Gerade bei diesen Patienten muß sorgfältig abgewogen werden, ob sie durch eine medikamentöse Schmerztherapie nicht noch mehr gefährdet werden. Mögliche unerwünschte Wirkungen auf Atmung [33], Herzkreislauf [11] und besonders die zerebrale Zirkulation müssen bedacht werden.

  • Auf der anderen Seite weisen Neugeborene und mehr noch Frühgeborene eine unvollständige Myelinisierung peripherer und zentraler Leitungsbahnen sowie eine geringe synaptische Verschaltung im ZNS auf. Es stellt sich somit die Frage, ob Neugeborene aufgrund der anatomisch-physiologischen Unreife ihres Nervensystems überhaupt zu Schmerzwahrnehmung und -Verarbeitung fähig sind und damit einer Schmerztherapie bedürfen.

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Authors
  1. E. P. Zilow
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  2. O. Linderkamp
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Editor information

Editors and Affiliations

  1. Zentrum für Anästhesiologie, Klinikum der Universität Ulm, Steinhövelstraße 9, D-7900, Ulm, Germany

    F. W. Ahnefeld  & T. Fösel (Oberarzt) &  (Oberarzt)

  2. Institut für Anästhesiologie, Universität Erlangen-Nürnberg, Maximiliansplatz 1, D-8520, Erlangen, Germany

    G.-B. Kraus (Oberärztin) & E. Rügheimer (Oberärztin) & 

  3. Klinik für Anästhesiologie und operative Intensivmedizin, Kliniken der Stadt Saarbrücken, Winterberg, Postfach 75, D-6600, Saarbrücken, Germany

    K.-H. Altemeyer (Chefarzt) (Chefarzt)

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© 1989 Springer-Verlag Berlin Heidelberg

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Zilow, E.P., Linderkamp, O. (1989). Praktische Anwendung von Opiaten bei Neugeborenen. In: Ahnefeld, F.W., Fösel, T., Kraus, GB., Rügheimer, E., Altemeyer, KH. (eds) Anästhesie bei Früh- und Neugeborenen. Kinderanästhesie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-74795-3_24

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  • DOI: https://doi.org/10.1007/978-3-642-74795-3_24

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-51207-3

  • Online ISBN: 978-3-642-74795-3

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