DerAnaesthesist.60451203.ger.abstr-passage-0
abstract
Rueckenmarknahe oder intrakranielle Haematome sind sehr seltene Komplikationen einer rueckenmarknahen Anaesthesie . Derzeit wird eine lebhafte Diskussion darueber gefuehrt , ob das Risiko solcher Blutungen durch die Thromboseprophylaxe mit niedrigdosiertem Heparin erhoeht wird . Da aufgrund geringer Inzidenz eine aussagekraeftige prospektive Studie nicht durchfuehrbar ist , werden in dieser Arbeit alle entsprechenden Fallberichte in der Literatur naeher analysiert . Insgesamt finden sich 4 rueckenmarknahe und 2 intrakranielle Haematome unter Thromboseprophylaxe mit unfraktioniertem Heparin sowie 6 rueckenmarknahe Haematome unter Thromboseprophylaxe mit verschiedenen niedermolekularen Heparinen . In keinem der Faelle kommt die Thromboseprophylaxe als alleinige Ursache der Haematomentstehung in Betracht : Bei 11 von 12 Patienten werden schwierige Punktionsverhaeltnisse angegeben . In 11 Faellen liegen drei oder mehr Risikofaktoren vor , darunter Gerinnungsstoerungen , gleichzeitige Gabe anderer gerinnungshemmender Medikamente und anatomische Besonderheiten . Blutungen nach rueckenmarknaher Anaesthesie sind demnach als multifaktorielles Geschehen anzusehen . Da die wenigen Fallberichte jeweils einem Kollektiv von mehreren Millionen Patienten ohne Komplikationen entstammen , erscheint die Anwendung sowohl des unfraktionierten als auch der niedermolekularen Heparine in Kombination mit einer rueckenmarknahen Anaesthesie nicht kontraindiziert . Fuer jeden Patienten sollte jedoch eine individuelle Nutzen/Risiko-Einschaetzung erfolgen .
DerAnaesthesist.60451203.ger.abstr-s1-r1-t1.1-t3.1
location_of
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s1-r2-t2.1-t5.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s1-r3-t3.1-t5.1
location_of
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s1-r4-t3.1-t2.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s1-r5-t1.1-t5.1
location_of
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s1-r6-t3.1-t2.1
location_of
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s1-r7-t2.1-t3.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s1-r8-t1.1-t2.1
location_of
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s1-r9-t5.1-t3.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s1-r10-t5.1-t2.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s1-r11-t3.1-t5.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s2-r1-t4.1-t3.1
affects
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s2-r2-t4.1-t2.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s2-r3-t3.1-t2.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s2-r4-t2.1-t4.1
produces
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s2-r5-t4.1-t3.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s2-r6-t2.1-t3.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s2-r7-t4.1-t2.1
affects
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s2-r8-t3.1-t4.1
produces
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s4-r1-t4.1-t6.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s4-r2-t1.1-t6.1
location_of
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s4-r3-t8.1-t5.1
disrupts
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s4-r4-t8.1-t3.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s4-r5-t4.1-t3.1
affects
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s4-r6-t1.1-t3.1
location_of
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s4-r7-t1.1-t4.1
produces
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s4-r8-t8.1-t6.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s4-r9-t5.1-t7.1
location_of
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s4-t7
DerAnaesthesist.60451203.ger.abstr-s4-r10-t4.1-t1.1
disrupts
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s4-r11-t4.1-t7.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s4-t7
DerAnaesthesist.60451203.ger.abstr-s4-r12-t1.1-t2.1
location_of
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s4-r13-t4.1-t2.1
affects
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s4-r14-t8.1-t3.1
affects
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s4-r15-t5.1-t6.1
location_of
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s4-r16-t4.1-t2.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s4-r17-t5.1-t4.1
produces
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s4-r18-t8.1-t2.1
affects
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s4-r19-t8.1-t1.1
disrupts
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s4-r20-t4.1-t7.1
affects
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s4-t7
DerAnaesthesist.60451203.ger.abstr-s4-r21-t8.1-t7.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s4-t7
DerAnaesthesist.60451203.ger.abstr-s4-r22-t1.1-t8.1
produces
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s4-r23-t5.1-t3.1
location_of
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s4-r24-t8.1-t4.1
interacts_with
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s4-r25-t4.1-t6.1
affects
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s4-r26-t8.1-t7.1
affects
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s4-t7
DerAnaesthesist.60451203.ger.abstr-s4-r27-t8.1-t2.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s4-r28-t4.1-t5.1
disrupts
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s4-r29-t5.1-t2.1
location_of
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s4-r30-t4.1-t3.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s4-r31-t1.1-t7.1
location_of
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s4-t7
DerAnaesthesist.60451203.ger.abstr-s4-r32-t8.1-t6.1
affects
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s4-r33-t4.1-t8.1
interacts_with
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s4-r34-t5.1-t8.1
produces
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s4-t8
DerAnaesthesist.60451203.ger.abstr-s5-r1-t2.1-t1.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s5-r2-t1.1-t3.1
occurs_in
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s5-r3-t4.1-t2.1
affects
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s5-r4-t4.1-t1.1
affects
DerAnaesthesist.60451203.ger.abstr-s8-t4
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s5-r5-t2.1-t3.1
occurs_in
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s5-r6-t1.1-t2.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s6-r1-t3.1-t2.1
diagnoses
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s7-r1-t3.1-t1.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s7-r2-t2.1-t3.1
location_of
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s7-r3-t2.1-t1.1
location_of
DerAnaesthesist.60451203.ger.abstr-s8-t2
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s7-r4-t1.1-t3.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-r1-t3.1-t6.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s8-r2-t3.1-t5.1
disrupts
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s8-r3-t1.1-t6.1
performs
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s8-r4-t5.1-t6.1
location_of
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s8-r5-t6.1-t3.1
uses
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-r6-t6.1-t1.1
affects
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-r7-t3.1-t1.1
occurs_in
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s9-t1
DerAnaesthesist.60451203.ger.abstr-s8-r8-t5.1-t3.1
produces
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-r9-t5.1-t3.1
location_of
DerAnaesthesist.60451203.ger.abstr-s8-t5
DerAnaesthesist.60451203.ger.abstr-s8-t3
DerAnaesthesist.60451203.ger.abstr-s8-r10-t6.1-t3.1
associated_with
DerAnaesthesist.60451203.ger.abstr-s8-t6
DerAnaesthesist.60451203.ger.abstr-s8-t3