Skip to main content
SpringerLink
Log in

Überwachung von Analgesie und Sedierung in der postoperativen Phase und in der Intensivmedizin

  • Conference paper
Totale intravenöse Anästhesie (TIVA)

Part of the book series: Klinische Anästhesiologie und Intensivtherapie ((KAI,volume 44))

  • 20 Accesses

Zusammenfassung

Bei der kardiovaskulären und der respiratorischen Therapie von Intensivpatienten ist es selbstverständlich, die Wirkungen und Nebenwirkungen der Therapie und der angewendeten Medikamente zu überwachen, wenn möglich sogar kontinuierlich. Hierzu stehen eine Reihe von invasiven und nichtinvasiven Monitorsystemen zur Verfügung, die entsprechend den individuellen medizinischen Problemen des Patienten abgestuft eingesetzt werden können.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Aldrete JA, Kroulik D (1970) A post-anesthetic recovery score. Anesth Anaig 49: 926

    Google Scholar 

  2. Arden JR, Holley FO, Stanski DR (1986) Increased sensitivity to etomidate in the elderly: initial distribution versus altered brain response. Anesthesiology 65: 1927

    Article  Google Scholar 

  3. Ausems ME, Hug CC, de Lange S (1983) Variable rate infusion of alfentanil as a supplement to nitrous oxide anesthesia for general surgery. Anesth Analg 62: 982–986

    CAS  Google Scholar 

  4. Ausems ME, Vuyk J, Hug CC, Stanski DR (1988) Comparison of a computer-assisted infusion versus intermittent bolus administration of alfentanil as a supplement to nitrous oxide for lower abdominal surgery. Anesthesiology 68: 851–861

    Article  PubMed  CAS  Google Scholar 

  5. Becker LD, Paulson BA, Miller RD, Severinghaus JW, Eger EI (1976) Biphasic respiratory depression after fentanyl-droperidol or fentanyl alone used to supplement nitrous oxide anesthesia. Anesthesiology 44: 291

    Article  PubMed  CAS  Google Scholar 

  6. Beran AV, Tolle CD, Huxtable RF (1981) Cutaneous blood flow and its relationship to transcutaneous 02/C02 measurements. Crit Care Med 9: 736

    Article  PubMed  CAS  Google Scholar 

  7. Bion JF, Logan BK, Newman PM, Brodie MJ, Oliver JS, Aitchinson TC, Ledingham IM (1986) Sedation in intensive care: morphine and renal function. Intens Care Med 12: 359–365

    Article  CAS  Google Scholar 

  8. Bodenham A, Park GR (1988) Alfentanil infusions in patients requiring intensive care. Clin Pharmacokinet 15: 216–226

    Article  PubMed  CAS  Google Scholar 

  9. Bodenham A, Bronwlie G, Dixon JS, Park GR (1988) Reversal of sedation by prolonged infusion of flumazenil (anexate, Ro 15–1788). Anaesthesia 43: 376–378

    Article  PubMed  CAS  Google Scholar 

  10. Böttger H, Oellerich M, Sybrecht M (1988) Use of aminoglycosides in critically ill patients: individualization or dosage using Bayesian statistics and pharmacokinetic principle. Ther Drug Monit 10: 280–286

    Article  PubMed  Google Scholar 

  11. Chauvin M, Sandouk P, Scherrmann JM, Farinotti R, Strumza P, Duvaldestin P (1987) Morphine pharmacokinetics in renal failure. Anesthesiology 66: 327–331

    Article  PubMed  CAS  Google Scholar 

  12. Chiappa KH, Ropper AH (1982) Evoked potentials in clinical medicine (in two parts). N Engl J Med 306: 1140–1150, 1206–1211

    Google Scholar 

  13. Cohen AT, Kelly DR (1987) Assessment of alfentanil by intravenous infusion as long-term sedation in intensive care. Anaesthesia 42: 545–548

    Article  PubMed  CAS  Google Scholar 

  14. Couture LJ, Edmonds JL (1989) Monitoring responsiveness during anesthesia. In: Jones G (ed) Depth of anaesthesia. Saunders, London

    Google Scholar 

  15. Day BL, Rothwell JC, Thompson PD et al. (1987) Motor unit firing rate during static contraction indicated by the surface EMG power. IEEE Trans Biomed Eng BME 30: 601–608

    Google Scholar 

  16. Doenicke A, Suttmann H, Müller OA, Dorow R, DukaT, Hoehe M (1986) Beeinflussung endokrinologischer Parameter durch Narko-Analgetika. In: Doenicke A (Hrsg) Schmerz- eine interdisziplinäre Herausforderung. Springer, Berlin Heidelberg New York

    Google Scholar 

  17. Edmonds HL, Paloheimo MPJ (1991) Intra-operative monitoring of awareness. In: Kay B (ed) Total intravenous anaesthesia. Elsevier, Amsterdam

    Google Scholar 

  18. Edmonds HL, Couture LJ, Stolzy SL et al. (1986) Quantitative surface electromyography in anesthesia and critical care. Int J Clin Monit Comput 3: 135–145

    Article  PubMed  Google Scholar 

  19. Edmonds HL, Stolzy SL, Couture LJ (1987) Surface electromyography during low- vigilance states. In: Rosen M, Lunn JN (eds) Consciousness, awareness and pain in general anesthesia. Butterworths, London

    Google Scholar 

  20. Erdmann K, Brandt L: Klinische Erfahrungen mit einem computerisierten EED-Monitor in der Carotis- und Herzchirurgie. In: Bergmann H, Steinbereithner K (eds) Eur Congr Anaesthesiol Proc. Maudrich, Wien München Bern

    Google Scholar 

  21. Evans JM, White DC. Oesophageal activity and anaesthesia. In: Rosen M, Lunn JN (eds) Consciousness, awareness and pain in general anaesthesia. Butterworths, London

    Google Scholar 

  22. Evans JM, Davies WL,Wise CC (1984) Lower oesophageal contractility: a new monitor of anaesthesia. Lancet I: 1151–1154

    Google Scholar 

  23. Gottardis M, Khunl-Brady KS, Koller W, Sigl G, Hackl JM (1989) Effect of prolonged sedation with propofol on erum triglyceride and cholesterol concentrations. Br J Anaesth 62: (1989) 393–384

    Article  PubMed  CAS  Google Scholar 

  24. Gottardis M, Schlager A, Benzer A, Hackl JM, Furtwängler W, Schmutzhard E (1991) Die „Spectral Edge Frequency“. Anästhesiol Intensivmed 32: 142–145

    Google Scholar 

  25. Hudson RJ (1990) Apnoea and unconsciousness after apparent recovery from alfentanil- supplemented anaesthesia. Can J Anaesth 37: 255–257

    Article  PubMed  CAS  Google Scholar 

  26. Hug CC (1985) Lipid solubility, pharmacokinetics, and the EEG: are You better off today than you were four years ago? Anesthesiology 62: 221–226

    Article  PubMed  CAS  Google Scholar 

  27. Hug CC (1991) Opioids Pharmacokinetics and anesthetic effects. In: ASA (ed) 1991 Annual refresher course lectures. American Society of Anesthesiologists, San Francisco

    Google Scholar 

  28. Hull CJ (1991) Drug distribution. In: Pharmacokinetics for anaesthesia. Butterworth & Heinemann, Oxford

    Google Scholar 

  29. Iberti TJ et al. (1990) Multicenter study of physician knowledge of the pulmonary artery catheter. JAMA 264: 2928–2932

    Article  PubMed  CAS  Google Scholar 

  30. Jensen MP, Karoly P, Braver S (1986) The measurement of clinical pain intensity: a comparison of six methods. Pain 27: 117–126

    Article  PubMed  CAS  Google Scholar 

  31. Jensen MP, Karoly P, O’Riordan EF, Bland F, Burns RS (1989) The subjective experience of acute pain. An assessment of the utility of 10 indices. Clin J Pain 5: 153–159

    Article  PubMed  CAS  Google Scholar 

  32. Kaiko RF, Foley KM, Grabinski PY, Heidrich G, Rogers AG, Inturrisi CE, Reidenberg MM (1983) central nervous system excitatory effects or meperidine in cancer patients. Ann Neurol 13: 180–185

    Google Scholar 

  33. Kamp H-D (1990) Atemdepression nach verschiedenen Methoden der NLA. In: Henschel W (Hrsg) Neuroleptanalgesie. Urban & Schwarzenberg, München

    Google Scholar 

  34. Kaufmann RD, Agleh KA, Belville JW (1979) Relative potencies and duration of action with respect to respiratory depression of intravenous meperidine, fentanyl and alphapro- dine in man. J Pharmacol Exp Ther 208: 73–79

    Google Scholar 

  35. Kelleher JF (1989) Pulse oximetry. J Clin Monit 5: 37–62

    Article  CAS  Google Scholar 

  36. Kochs E, Schulte am Esch J (1984) Hormone des Hypophysen-Nebennierensystems bei Patienten unter Langzeitsedierung mit Etomidate und Fentanyl. Anästhesist 33: 402–407

    CAS  Google Scholar 

  37. Kochs E, Schulte am Esch J (1988) Neurophysiologisches Monitoring (Elektroenzephalogramm evozierte Potentiale) und Benzodiazepinwirkung. Anästh Intensivther Notfallmed 23: 145–152

    Article  PubMed  CAS  Google Scholar 

  38. Kochs E, Bischoff P, Rust U, Schulte am Esch J (1988) Beeinflussung des Hypophysen- Nebennierenrinden-Systems durch Langzeitanalgosedierung. In: Schulte am Esch J, Benzer H (Hrsg) Analgosedierung des Intensivpatienten. Springer, Berlin Heidelberg New York

    Google Scholar 

  39. Krane BD, Kreutz JM, Johnson DL, Mazuzan JE (1990) Alfentanil and delayed respiratory depression: Case studies and review. Anesth Analg 70: 557–561

    Article  PubMed  CAS  Google Scholar 

  40. Krüger J, Steudel WI (1983) Korrelation zwischen EEG (FFT) und Bewußtseinsgrad bei Patienten in der frühen posttraumatischen Phase. EEG EMG 24: 115–168

    Google Scholar 

  41. Ledingham IM, Watt I (1984) Influence of sedation on mortality in critically ill multiple trauma patients. Lancet I: 1270

    Google Scholar 

  42. Ledingham IM, Finlay WEI, Watt I et al. (1983) Etomidate and adrenocortical function. Lancet I: 1434

    Google Scholar 

  43. Lehmann KA (1986) Pharmakokinetik: gibt es analgetische Blutkonzentrationen? In: Kettler D, Crozier T, Metzler H (Hrsg) Urban & Schwarzenberg, München

    Google Scholar 

  44. Lehmann KA (1988) Analgosedierung mit Opioiden. In: Schulte am Esch J, Benzer H (Hrsg) Analgosedierung des Intensivpatienten. Springer, Berlin Heidelberg New York

    Google Scholar 

  45. Lehmann KA (Hrsg) (1990) Schmerzmessung und -dokumentation. In: Der postoperative Schmerz. Springer, Berlin Heidelberg New York

    Google Scholar 

  46. Lenhart F-P, Frey L,Wilm V,Taeger K (1988) Sedierung langzeitbeatmeter Patienten mit Methohexital und Opioiden. In: Link J, Eyrich K (Hrsg) Analgesie und Sedierung in der Intensivmedizin. Springer, Berlin Heidelberg New York

    Google Scholar 

  47. Ling GSF, Spiegel K, Nishimura SL, Pasternak GW (1983) Dissociation of morphine’s analgesic and respiratory depressant actions. Eur J Pharmacol 86: 487–488

    Article  PubMed  CAS  Google Scholar 

  48. Link J, Papadopoulos G, Striebel HW, Heinemeyer G, Rohling R (1988) Analgesie und Sedierung während Intensivtherapie - Strategie und Taktik. In: Link J, Eyrich K (Hrsg) Springer, Berlin Heidelberg New York

    Google Scholar 

  49. Litscher G, Pfurtscheller G, Schwarz G, List W (1987) Akustisch evozierte Hirnstammpotentiale. Anaesthesist 36: 555–560

    PubMed  CAS  Google Scholar 

  50. Mahla ME,White SE, Moneta MD (1988) Delayed respiratory depression after alfentanil. Anesthesiology 69: 593–595

    Article  Google Scholar 

  51. Mann HJ, Fuhs DW, Cerra FB (1987) Pharmacokinetics and pharmacodynamics in critically ill patients. World J Surg 11: 210–217

    Article  PubMed  CAS  Google Scholar 

  52. Mapleson WW (1973) Br J Anaesth 45: 319–334

    Article  PubMed  CAS  Google Scholar 

  53. Marks RM, Sachar E J (1973) Undertreatment of medical inpatients with narcotic analgesics. Ann Int Med 78: 173–181

    PubMed  CAS  Google Scholar 

  54. McGillard KL, Takemori AE (1978) Antagonism by naloxone of narcotic-induced respiratory depression and analgesia. J Pharmacol Exp Ther 207: 494–503

    Google Scholar 

  55. Meldrum BS, Brierley JB (1969) Brain damage in the rhesus monkey resulting from profound arterial hypotension. II. Changes in spontaneous and evoked electrical activity of the neocortex. Brain Res 13: 101–118

    Article  PubMed  CAS  Google Scholar 

  56. Mertes N, Thülig B, Zander J, Schöppner H (1989) Long-term sedation with continuous infusion of propofol in ventilated intensive care patients: preliminary experiences over 120 hours in six patients. J Drug Dev 2: 77–78

    Google Scholar 

  57. Oldenhof H, de Jong M, Steenhoek A, Janknegt R (1988) Clinical pharmacokinetics of midazolam in intensive care patients, a wide interpatients variability? Clin Pharmacol Ther 43: 263–269

    CAS  Google Scholar 

  58. O’ullivan GF, Park GR (1990) The assessment of sedation in critically ill patients. Clin Int Care 1: 116–122

    Google Scholar 

  59. Paloheimo M (1990) Quantitative surface electromyography applications in anesthesiology and critical care. Acta Anaesthesiol Scand 34: 1–83

    Article  Google Scholar 

  60. Papadopoulos G, Striebel HW, Heinemeyer G, Link J (1988) Sedierung mit Diazepam bei langzeitbeatmeten Patienten unter Basisanalgesie mit Neuroleptanalgesie: Pharmakokinetik - Pharmakodynamik. In: Link J, Eyrich K (Hrsg) Analgesie und Sedierung in der Intensivmedizin. Springer, Berlin Heidelberg New York

    Google Scholar 

  61. Penfold NW, Park GR (1990) Effects of organ failure and therapy on drug metabolism. Curr Op Anaesth 3: 235–240

    Article  Google Scholar 

  62. Rampil IJ, Sasse FJ, Smith NT, Hoff BH, Flemming DC (1980) Spectral edge frequency - a new correlate of anesthetic depth. Anesthesiology 53: 512

    Article  Google Scholar 

  63. Riffel B, Sommer-Edlinger B, Kroiss H (1991) Somatosensorisch evozierte Potentiale (SEP). In: Stöhr M, RiffelB, Pfadenhauer K (Hrsg) Neuro-physiologischeUntersuchungsmethoden in der Intensivmedizin. Springer, Berlin Heidelberg New York

    Google Scholar 

  64. Rohling R, Papadopoulos G, Striebel HW, Link J, Heinemeyer G (1988) Basisanalgose- dierung mit Fentanyl und Dehydrobenzperidol bei beatmeten Intensivpatienten. In: Link J, Eyrich K (Hrsg) Springer, Berlin Heidelberg New York

    Google Scholar 

  65. Russell IF (1989) Conscious awareness during general anaesthesia: relevance of autonomic signs and isolated arm movements as guides to depth of anaesthesia. In: Jones JG (ed) BailliÀre’s clinical anaesthesiology. BailliÀre-Tindall, London

    Google Scholar 

  66. Schwarz G, Pfurtscheller G, List W (1986) Akustisch evozierte Hirnstammpotentiale - Möglichkeiten und Probleme auf der Intensivstation. Anästh Intens Notfallmed 21: 262

    Article  CAS  Google Scholar 

  67. Schwilden H (1988) Sedierung und EEG bei Intensivpatienten. In: Link J, Eyrich K (Hrsg) Analgesie und Sedierung in der Intensivmedizin. Springer, Berlin Heidelberg New York

    Google Scholar 

  68. Schwilden H, Stoeckel H (1987) The unprocessed EED. In: Rosen M, Nunn JN (eds) Consciousness, awareness and pain in general anaesthesia. Butterworths, London

    Google Scholar 

  69. Sear JW, Fisher A, Summerfield RJ (1987) Is alfentanil by infusion useful for sedation on ITU? Eur J Anaesth Suppl 1: 55–61

    CAS  Google Scholar 

  70. Severinghaus JW (1982) Transcutaneous gas analysis. Respir Care 27: 152

    Google Scholar 

  71. Severinghaus JW (1991) Oximetry: what does it tell you? In: ASA (ed) 1991 Annual refresher course lectures. San Francisco

    Google Scholar 

  72. Sinclair ME, Suter PM (1988) Detection of overdosage of sedation in a patient with renal failure by the absence of lower oesophageal motility. Intens Care Med 14: 69–71

    Article  CAS  Google Scholar 

  73. Steward DJ (1975) A simplified scoring system for the post-operative recovery room. Can Anesth Soc J 22: 111

    Article  CAS  Google Scholar 

  74. Stoeckel H, Hengstmann JH, J Schüttler (1979) Pharmacokinetics of fentanyl as a possible explanation for recurrence of respiratory depression. Br J Anaesth 51: 741

    Article  PubMed  CAS  Google Scholar 

  75. Stoeckel H, Schwilden H (1987) Median EEG frequency. In: Rosen M, Lunn JN (eds) Consciousness, awareness and pain in general anaesthesia. Butterworths, London

    Google Scholar 

  76. Stöhr M, Riffel B, Pfadenhauer K (1991) Neurophysiologische Untersuchungsmethoden in der Intensivmedizin. Springer, Berlin Heidelberg New York

    Google Scholar 

  77. Thornton C, Konieczko K, Jones JG et al. (1988) Effect of surgical stimulation on the auditory evoked response. Br J Anaesth 60: 372–378

    Article  PubMed  CAS  Google Scholar 

  78. Tremper KK, Barker SJ (1989) Pulse oximetry. Anesthesiology 70: 98–108

    CAS  Google Scholar 

  79. Tremper KK, William MD, Shoemaker C (1981) Transcutaneous osygen monitoring of critically ill adults with and without low flow shock. Crit Care Med 9: 706

    Article  PubMed  CAS  Google Scholar 

  80. Velasco M,Velasco F, Castaneda R et al. (1984) Effect of fentanyl and naloxone on human somatic and auditory evoked potential components. Neuropharmacology 23: 359–366

    Google Scholar 

  81. Veselis RA, Reinsei R, Sommer S, Carlon G (1991) Use of neural network analysis to classify electroencephalographic patterns against depth of midazolam sedation in intensive care unit patients. J Clin Monit 7: 259–267

    Article  PubMed  CAS  Google Scholar 

  82. White PF (1991) Patient-controlled analgesia: The use of on-demand opioids in the management of acute pain. In: Estafanous FG (ed) Opioids in anesthesia I I. Butterworth & Heinemann, Boston

    Google Scholar 

  83. Wukitsch MW, Petterson MT,Tobler DR, Pologe JA (1988) Pulse oximetry: Analysis of theory, technology and practice. J Clin Monit 4: 290–301

    Google Scholar 

  84. Yelderman M, New W (1983) Evaluation of pulse oximetry. Anesthesiology 59: 349

    Article  PubMed  CAS  Google Scholar 

  85. Zegers de Beyl D, Mavroudakis N, Brunko E (1989) Monitoring brain failure using evoked potentials. In: Bihari D, Holaday JW (eds) Brain failure. Springer, Berlin Heidelberg New York

    Google Scholar 

Download references

Authors
  1. J. Zander
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Klinik für Anästhesiologie, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 6500, Mainz, Germany

    W. Dick Univ.-Prof. Dr. Dr. h.c. (Direktor), B. Eberle Dr. , H. Gervais Dr. , W. Heinrichs Priv.-Doz. Dr.  & A. Klein Dr. (Direktor), , ,  & 

  2. Klinik für Anästhesiologie, Klinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, D-6500, Mainz, Germany

    W. Dick Univ.-Prof. Dr. Dr. h.c. (Direktor) (Direktor)

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Zander, J. (1993). Überwachung von Analgesie und Sedierung in der postoperativen Phase und in der Intensivmedizin. In: Dick, W., Eberle, B., Gervais, H., Heinrichs, W., Klein, A. (eds) Totale intravenöse Anästhesie (TIVA). Klinische Anästhesiologie und Intensivtherapie, vol 44. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77966-4_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-77966-4_24

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56248-1

  • Online ISBN: 978-3-642-77966-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation