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Erschienen in: Notfall +  Rettungsmedizin 3/2013

01.05.2013 | Originalien

Lokalanästhetikaintoxikation und „lipid resuscitation“

verfasst von: Dr. C. Plata, B. W. Böttiger, O. Dagtekin

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 3/2013

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Zusammenfassung

Hintergrund

Tierexperimentelle Studien und zahlreiche Fallberichte legen die Vermutung nahe, dass die Therapie der Lokalanästhetikaintoxikation mit Lipidinfusionen effektiv ist. Der Wirkmechanismus ist noch unbekannt, es existieren jedoch zwei Theorien. Zum einen die Metabolismus-Theorie, die besagt, dass die Gabe von Lipiden bei Intoxikationen mit Lokalanästhetika zu einer verbesserten Stoffwechselsituation des Herzens und des Gehirns führen und dadurch die Intoxikationssymptome abgeschwächt werden. Die zweite Theorie ist die Lipidsenken-Theorie („lipid sink“). Diese Lipidsenken-Theorie wird in letzter Zeit favorisiert und besagt, dass die Lipide einen zusätzlichen intravasalen Raum oder ein Kompartiment schaffen, wohin das Lokalanästhetikum verschwinden kann.

Methode

Selektive Recherche der Literatur und Homepages.

Schlussfolgerungen

Die Lipidtherapie hat ihre Wirksamkeit nicht nur bei Lokalanästhetikaintoxikationen, sondern auch bei Intoxikationen mit anderen lipophilen Substanzen, z. B. mit (trizyklischen) Antidepressiva, Antiepileptika, lipophilen β-Blockern oder Kalziumkanalblockern gezeigt. Nationale und internationale Fachgesellschaften empfehlen die Gabe von Lipidemulsionen zur Therapie der Lokalanästhetikaintoxikationen. Weitere Fallbeispiele und tierexperimentelle Studien werden den Fokus auf die Frage nach Nebenwirkungen, optimaler Dosierung und der Wirksamkeit bei Intoxikationen mit anderen Medikamenten lenken müssen.
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Metadaten
Titel
Lokalanästhetikaintoxikation und „lipid resuscitation“
verfasst von
Dr. C. Plata
B. W. Böttiger
O. Dagtekin
Publikationsdatum
01.05.2013
Verlag
Springer-Verlag
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 3/2013
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-013-1687-9

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