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Postoperative Schmerztherapie nach Hals-Nasen-Ohren-ärztlichen Eingriffen

Management of postoperative pain in ear–nose–throat surgery

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Zusammenfassung

Die postoperative Schmerztherapie muss bei der großen Bandbreite Hals-Nasen-Ohren-ärztlicher Eingriffe individuell sowohl an die Invasivität als auch an das subjektive Schmerzempfinden des Patienten angepasst werden. Eine effektive postoperative Schmerztherapie gliedert sich in eine regelmäßig verabreichte Basismedikation sowie die additiv verabreichte Bedarfsmedikation. Die subjektiv vom Patienten angegebene Schmerzintensität sollte als Grundlage für die Dosisanpassung dienen und ist für eine schnelle Genesung essenziell.

Abstract

The degree of pain following different types of ear–nose–throat surgery varies greatly and must be adjusted on an individual basis. Post-operative pain therapy can be classified into basic pain therapy and additive pain therapy (as needed). Effective pain therapy can lead to lower morbidity and to considerable economic advantages. The subjective pain intensity experienced by patient should be the basis for the dose adaptation and is essential for rapid recovery.

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Literatur

  1. Akinpelu AO, Olowe OO (2002) Correlative study of 3 pain rating scales among obstetric patients. Afr J Med Med Sci 31:123–126

    PubMed  CAS  Google Scholar 

  2. Laubenthal H, Becker M, Neugebauer E (2006) Guideline: „Treatment of acute perioperative and posttraumatic pain“. Updating from the S2- to the S3-level: a preliminary report. Anasthesiol Intensivmed Notfallmed Schmerzther 41:470–472

    Article  PubMed  Google Scholar 

  3. Johansson K, Nuutila L, Virtanen H et al (2005) Preoperative education for orthopaedic patients: systematic review. J Adv Nurs 50:212–223

    Article  PubMed  Google Scholar 

  4. 21 Moore KN, Estey A (1999) The early post-operative concerns of men after radical prostatectomy. J Adv Nurs 29:1121–1129

    Article  PubMed  CAS  Google Scholar 

  5. Troidl H, Neugebauer E (1990) Acute pain in surgery. Clinical significance, methods for measuring and therapy. Chirurg 61:485–493

    PubMed  CAS  Google Scholar 

  6. Dertwinkel R, Wiebalck A, Linstedt U et al (2002) Modern pain therapy. Internist (Berl) 43:779–786

  7. Neugebauer E, Hempel K, Sauerland S et al (1998) The status of perioperative pain therapy in Germany. Results of a representative, anonymous survey of 1,000 surgical clinic. Pain Study Group. Chirurg 69:461–466

    Article  PubMed  CAS  Google Scholar 

  8. Jage J (2005) Opioid tolerance and dependence – do they matter? Eur J Pain 9:157–162

    Article  PubMed  CAS  Google Scholar 

  9. Dahl JB, Hjortso NC, Lund C et al (1990) Treatment of postoperative pain. Ugeskr Laeger 152:3438–3444

    PubMed  CAS  Google Scholar 

  10. Kehlet H, Dahl JB (2003) Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 362:1921–1928

    Article  PubMed  Google Scholar 

  11. Romsing J, Moiniche S, Dahl JB (2002) Rectal and parenteral paracetamol, and paracetamol in combination with NSAIDs, for postoperative analgesia. Br J Anaesth 88:215–226

    Article  PubMed  CAS  Google Scholar 

  12. Zernikow B, Hechler T (2008) Pain therapy in children and adolescents. Dtsch Arztebl Int. 105: 511-521

    Google Scholar 

  13. Beck DH, Schenk M, Doepfmer U, Kox WJ (2000) Rectal paracetamol has a significant morphine-sparing effect after hysterectomy. Br J Anaesth 85:658–659

    PubMed  CAS  Google Scholar 

  14. Mantzke US, Brambrink AM (2002) Paracetamol in childhood. Current state of knowledge and indications for a rational approach to postoperative analgesia. Anaesthesist 51:735–746

    Article  PubMed  CAS  Google Scholar 

  15. Aken H, Thys L, Veekman L, Buerkle H (2004) Assessing analgesia in single and repeated administrations of propacetamol for postoperative pain: comparison with morphine after dental surgery. Anesth Analg 98:159–165 (table)

    Article  PubMed  Google Scholar 

  16. Edwards RR, Fillingim RB (2001) Effects of age on temporal summation and habituation of thermal pain: clinical relevance in healthy older and younger adults. J Pain 2:307–317

    Article  PubMed  CAS  Google Scholar 

  17. Ibanez L, Vidal X, Ballarin E, Laporte JR (2005) Agranulocytosis associated with dipyrone (metamizol). Eur J Clin Pharmacol 60:821–829

    Article  PubMed  CAS  Google Scholar 

  18. Marret E, Kurdi O, Zufferey P, Bonnet F (2005) Effects of nonsteroidal antiinflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials. Anesthesiology 102:1249–1260

    Article  PubMed  CAS  Google Scholar 

  19. Goldstein JL, Huang B, Amer F, Christopoulos NG (2004) Ulcer recurrence in high-risk patients receiving nonsteroidalanti-inflammatory drugs plus low-dose aspirin: results of a post HOC subanalysis. Clin Ther 26:1637–1643

    Article  PubMed  CAS  Google Scholar 

  20. Krishna S, Hughes LF, Lin SY (2003) Postoperative hemorrhage with nonsteroidal anti-inflammatory drug use after tonsillectomy: a meta-analysis. Arch Otolaryngol Head Neck Surg 129:1086–1089

    Article  PubMed  Google Scholar 

  21. Lee A, Cooper MC, Craig JC et al (2004) Effects of nonsteroidal anti-inflammatory drugs on postoperative renal function in adults with normal renal function. Cochrane Database Syst Rev CD002765-

  22. Forrest JB, Camu F, Greer IA et al (2002) Ketorolac, diclofenac, and ketoprofen are equally safe for pain relief after major surgery. Br J Anaesth 88:227–233

    Article  PubMed  CAS  Google Scholar 

  23. Silvasti M, Tarkkila P, Tuominen M et al (1999) Efficacy and side effects of tramadol versus oxycodone for patient-controlled analgesia after maxillofacial surgery. Eur J Anaesthesiol 16:834–839

    PubMed  CAS  Google Scholar 

  24. Mom T, Bazin JE, Commun F et al (1998) Assessment of postoperative pain after laryngeal surgery for cancer. Arch Otolaryngol Head Neck Surg 124:794–798

    Article  PubMed  CAS  Google Scholar 

  25. Pickering AE, Bridge HS, Nolan J, Stoddart PA (2002) Double-blind, placebo-controlled analgesic study of ibuprofen or rofecoxib in combination with paracetamol for tonsillectomy in children. Br J Anaesth 88:72–77

    Article  PubMed  CAS  Google Scholar 

  26. Morlion B, Ebner E, Weber A et al (1999) Influence of bolus size on efficacy of postoperative patient-controlled analgesia with piritramide. Br J Anaesth 82:52–55

    Article  PubMed  CAS  Google Scholar 

  27. Grape S, Schug SA, Lauer S, Schug BS (2010) Formulations of fentanyl for the management of pain. Drugs 70:57–72

    Article  PubMed  CAS  Google Scholar 

  28. Sarny S, Habermann W, Ossimitz G, Stammberger H (2012) Significant post-tonsillectomy pain is associated with increased risk of hemorrhage. Ann Otol Rhinol Laryngol 121:776–781

    PubMed  Google Scholar 

  29. Costantini R, Affaitati G, Fabrizio A, Giamberardino MA (2011) Controlling pain in the post-operative setting. Int J Clin Pharmacol Ther 49:116–127

    Article  PubMed  CAS  Google Scholar 

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Send, F. Bootz und M.O. Thudium geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde/ Chirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland

    T. Send & F. Bootz

  2. Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Bonn, Bonn, Deutschland

    M.O. Thudium

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  1. T. Send
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  2. F. Bootz
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  3. M.O. Thudium
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Correspondence to T. Send.

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Send, T., Bootz, F. & Thudium, M. Postoperative Schmerztherapie nach Hals-Nasen-Ohren-ärztlichen Eingriffen. HNO 61, 883–891 (2013). https://doi.org/10.1007/s00106-013-2734-z

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  • DOI: https://doi.org/10.1007/s00106-013-2734-z

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