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Mikrochirurgische Eingriffe zur Bildung von Anastomosen stellen den Anästhesisten vor neue Herausforderungen im perioperativen Setting. Trotz zunehmender Bedeutung und steigender Durchführung existierte bislang keine Leitlinie zum perioperativen Management dieser Patienten. Der Anästhesist kann durch ein durchdachtes prä-/intra- und postoperatives Vorgehen den Erfolg der Operation (z. B. erfolgreiche Perfusion einer Lappenplastik) wesentlich mitbestimmen. Betroffene Patienten müssen bereits präoperativ sorgfältig v. a. auf das Vorliegen von Komorbiditäten hinsichtlich des erhöhten Risikos für ein schlechtes postoperatives Outcome evaluiert werden. Perioperativ kommen der Wahl des Narkoseverfahrens sowie des Infusions‑, Blutzucker‑, Temperatur- und Transfusionsmanagements große Bedeutung zu. Postoperativ sollte neben einer suffizienten Analgesie eine engmaschige Kontrolle idealerweise auf einer Überwachungsstation erfolgen, um Komplikationen frühestmöglich aufdecken zu können.
Der Anaesthesist – Springer Journals
Published: Aug 1, 2017
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