DerAnaesthesist.40430605.ger.abstr-passage-0
abstract
Etomidat ist ein Hypnotikum mit hervorragender kardiovaskulaerer Stabilitaet und rascher Elimination , das sich als Bestandteil einer totalen intravenoesen Anaesthesie bei kardialen Risikopatienten anbietet . Die nachgewiesene Hemmung der Kortisolsynthese fuehrte dazu , dass von einer repetitiven oder kontinuierlichen Etomidatgabe abgeraten wurde . Hinweise auf eine unvollstaendige Inhibition der Kortisolsynthese machen eine erneute Ueberpruefung der endokrinen Wirkungen erforderlich . 19 Patienten zur Myokardrevaskularisation nahmen an der Studie teil . Sie erhielten randomisiert eine intravenoese Anaesthesie mit Etomidat-Fentanyl oder Midazolam-Fentanyl . Es wurden serielle Bestimmungen der Parameter Kortisol , Aldosteron , ACTH , -Endorphin , Adrenalin und Noradrenalin durchgefuehrt sowie mehrfache Nebennierenrindenstimulationen mit exogenem ACTH . Es zeigte sich , dass die Kortisolkonzentrationen in beiden Gruppen sich nicht signifikant unterschieden , bis auf den ersten postoperativen Tag , an dem die Kortisolspiegel in der Etomidatgruppe signifikant hoeher lagen . Die ACTH- , -Endorphin- und Katecholaminkonzentrationen lagen postoperativ in der Etomidatgruppe signifikant hoeher als in der Midazolamgruppe . Nach diesen Ergebnissen kann die Hypothese einer unmittelbaren Gefaehrdung aufgrund einer etomidatbedingten Kortisolsynthesehemmung im perioperativen Zeitraum nicht aufrechterhalten werden . Vielmehr sollte die totale intravenoese Anaesthesie mit Etomidat in Kombination mit einem Opiat in der Kardiochirurgie einer neuerlichen , umfangreichen Ueberpruefung unterzogen werden .
DerAnaesthesist.40430605.ger.abstr-s1-r1-t3.1-t1.1
uses
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s1-r2-t2.1-t1.1
uses
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s4-r1-t1.1-t2.1
performs
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s4-r2-t2.1-t1.1
affects
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s6-r1-t3.1-t4.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s6-r2-t1.1-t7.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s6-r3-t7.1-t5.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s6-r4-t3.1-t2.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s6-r5-t6.1-t4.1
produces
DerAnaesthesist.40430605.ger.abstr-s6-t6
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s6-r6-t1.1-t5.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s6-r7-t7.1-t3.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s6-r8-t2.1-t7.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s6-r9-t1.1-t3.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s6-r10-t6.1-t3.1
produces
DerAnaesthesist.40430605.ger.abstr-s6-t6
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s6-r11-t4.1-t2.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s6-r12-t7.1-t1.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s6-r13-t2.1-t5.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s6-r14-t5.1-t4.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s6-r15-t3.1-t7.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s6-r16-t2.1-t3.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s6-r17-t6.1-t2.1
produces
DerAnaesthesist.40430605.ger.abstr-s6-t6
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s6-r18-t5.1-t2.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s6-r19-t3.1-t5.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s6-r20-t2.1-t1.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s6-r21-t4.1-t7.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s6-r22-t6.1-t1.1
produces
DerAnaesthesist.40430605.ger.abstr-s6-t6
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s6-r23-t4.1-t5.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s6-r24-t7.1-t4.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s6-r25-t3.1-t1.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s6-r26-t5.1-t7.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s6-r27-t1.1-t4.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s6-r28-t6.1-t7.1
produces
DerAnaesthesist.40430605.ger.abstr-s6-t6
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s6-r29-t4.1-t3.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s6-r30-t7.1-t2.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s6-t7
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s6-r31-t1.1-t2.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s6-r32-t4.1-t1.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s6-r33-t2.1-t4.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s10-t4
DerAnaesthesist.40430605.ger.abstr-s6-r34-t5.1-t3.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s6-r35-t5.1-t1.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s6-r36-t6.1-t5.1
produces
DerAnaesthesist.40430605.ger.abstr-s6-t6
DerAnaesthesist.40430605.ger.abstr-s6-t5
DerAnaesthesist.40430605.ger.abstr-s8-r1-t1.1-t2.1
affects
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s10-r1-t1.1-t3.1
uses
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s10-r2-t3.1-t2.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s10-r3-t3.1-t2.1
uses
DerAnaesthesist.40430605.ger.abstr-s10-t3
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s10-r4-t1.1-t2.1
uses
DerAnaesthesist.40430605.ger.abstr-s10-t1
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s10-r5-t2.1-t3.1
interacts_with
DerAnaesthesist.40430605.ger.abstr-s10-t2
DerAnaesthesist.40430605.ger.abstr-s10-t3