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Präoperative Dauertherapie

Preoperative long-term therapy

  • Klinische Pharmakologie
  • Published:
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Zusammenfassung

Ein Großteil der Patienten, die sich chirurgischen Eingriffen unterziehen, nimmt bereits präoperativ Medikamente ein. Nur bei einem Teil der Patienten steht die Medikamenteneinnahme in direkter Beziehung zum geplanten chirurgischen Eingriff. Der überwiegende Teil erhält eine Dauermedikation aufgrund vorbestehender Erkrankungen. Im Vordergrund stehen dabei behandlungspflichtige Erkrankungen des kardiovaskulären, pulmonalen und endokrinologischen Systems. Die Anzahl und die Art der präoperativen Pharmakotherapie ist mit dem Alter des Patienten, der Komorbidität und dem Geschlecht korreliert. Darüber hinaus erhalten Patienten höherer ASA-Klassen mehr Medikamente, da sie häufiger unter Erkrankungen des kardiovaskulären, pulmonalen, neurologischen und endokrinologischen Formenkreises leiden. Der Umgang mit der präoperativen Dauertherapie ist für die Planung des anästhesiologischen und auch des chirurgischen Vorgehens von praktischer Bedeutung. Insbesondere auf dem Gebiet der gerinnungsaktiven Substanzen und anderer Medikamente, die abgesetzt oder umgestellt werden sollten, ist eine enge Kooperation der beteiligten Disziplinen erforderlich. In dieser Übersicht wird der Umgang mit der präoperativen Medikation für die wichtigsten Krankheitsbilder und Organsysteme besprochen und anhand der zur Verfügung stehenden Literatur kritisch diskutiert.

Abstract

A large number of patients undergoing elective surgical procedures already take routine medication preoperatively. The majority of these patients use drugs for therapy of preexisting cardiovascular, pulmonary or endocrinological diseases which are independent of the planned surgical procedure. The number and type of preoperative drug therapy are correlated to age, gender and co-morbidity of the patients. Furthermore, patients with higher ASA-classes usually take more drugs, as they suffer from several medical diseases. Information about the perioperative handling of routine drug therapy is important for the planning of anaesthesia and surgery. A close cooperation of all medical specialities involved is necessary, in particular when patients take anticoagulants or other substances which should be withdrawn or replaced. This review focuses on the handling of routine preoperative medication by the anaesthesiologist in the light of available literature.

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Authors and Affiliations

  1. Bundesinstitut für Arzneimittel und Medizinprodukte, Bonn

    K. Buhre

  2. Klinik für Anästhesiologie, Universitätsklinikum, Aachen

    L. de Rossi

  3. Division Perioperative Medicine and Emergency Care, University Medical Center, Utrecht, The Netherlands

    W. Buhre

  4. Division Perioperative and Emergency Care, Department of Anesthesiology, University Medical Center, E.03.511, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands

    W. Buhre

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  1. K. Buhre
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  2. L. de Rossi
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  3. W. Buhre
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Buhre, K., de Rossi, L. & Buhre, W. Präoperative Dauertherapie. Anaesthesist 54, 902–913 (2005). https://doi.org/10.1007/s00101-005-0903-5

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