DerAnaesthesist.50440291.ger.abstr-passage-0
abstract
Die kontrollierte Hypotension ist eine pharmakologisch induzierte Blutdrucksenkung auf einen arteriellen Mitteldruck von 50-60 mm Hg beim anaesthesierten und kontrolliert beatmeten Patienten , oft ergaenzt durch Lagerungsmassnahmen , die das Operationsgebiet ueber die Herzebene anheben . Wichtigstes Ziel der kontrollierten Hypotension ist die Verminderung intraoperativer Blutverluste und damit des Bedarfs an Transfusionsblut . Im guenstigen Fall koennen durch die kontrollierte Blutdrucksenkung intraoperative Blutverluste um mehr als 50% vermindert werden ; allerdings ist die Wirkung sehr variabel und individuell nicht vorhersehbar . Die Technik der kontrollierten Hypotension ist weitgehend vereinheitlicht worden und erfolgt primaer mit rasch und kurz wirkenden Vasodilatatoren wie Nitroprussid , Nitroglyzerin oder Urapidil , ergaenzt durch -Blocker und/oder Inhalationsanaesthetika wie Isofluran , um die Wirkung und Steuerbarkeit zu verbessern und die erforderliche Dosis zu reduzieren sowie unerwuenschte Wirkungen ( Reflextachykardie Tachyphylaxie , Reboundhypertonie ) , zu vermeiden . Durch Lagerung des Operationsgebiets ueber die Herzebene kann die Durchblutung waehrend der kontrollierten Hypotension regional weiter vermindert und der venoese Abfluss besser drainiert werden . Hauptgefahr der kontrollierten Hypotension ist die unzureichende Durchblutung der Organe , insbesondere von Herz und Gehirn mit nachfolgender Schaedigung ( Apoplex bzw. neurologische Ausfaelle , Myokardinfarkt ) , weiterhin die Zunahme des intrakraniellen Blutvolumens bei neurochirurgischen Patienten . Wichtigste Kontraindikationen sind daher die koronare Herzkrankheit , die Hypertonie mit Arteriolosklerose der Hirngefaesse , zerebrale Durchblutungsstoerungen sowie der erhoehte intrakranielle Druck . Bei strikter Beachtung der Kontraindikationen , sorgfaeltiger Auswahl und Vorbereitung des Patienten , korrekter technischer Durchfuehrung und essentiellem Monitoring ist die Komplikationsrate der kontrollierten Hypotension gering . Die Mortalitaet wird mit 0,02-0,06% angegeben .
DerAnaesthesist.50440291.ger.abstr-s1-r1-t3.1-t2.1
measurement_of
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s1-r2-t2.1-t1.1
result_of
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s1-r3-t1.1-t4.1
occurs_in
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s1-r4-t5.1-t1.1
location_of
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s1-r5-t1.1-t2.1
result_of
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s1-r6-t5.1-t2.1
location_of
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s1-r7-t1.1-t2.1
evaluation_of
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s3-r1-t2.1-t1.1
affects
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s4-r1-t3.1-t4.1
interacts_with
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s4-r2-t4.1-t6.1
diagnoses
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s4-r3-t5.1-t2.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s4-r4-t2.1-t6.1
associated_with
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s4-r5-t4.1-t1.1
issue_in
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s4-r6-t2.1-t7.1
result_of
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s4-r7-t7.1-t2.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s4-r8-t6.1-t1.1
issue_in
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s4-r9-t6.1-t7.1
evaluation_of
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s4-r10-t7.1-t5.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s4-r11-t6.1-t5.1
evaluation_of
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s4-r12-t2.1-t5.1
result_of
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s4-r13-t4.1-t2.1
affects
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s4-r14-t3.1-t6.1
diagnoses
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s4-r15-t6.1-t7.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s4-r16-t5.1-t6.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s4-r17-t4.1-t2.1
diagnoses
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s4-r18-t3.1-t1.1
issue_in
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s4-r19-t3.1-t7.1
affects
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s4-r20-t4.1-t7.1
affects
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s4-r21-t5.1-t1.1
issue_in
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s4-r22-t7.1-t6.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s4-r23-t2.1-t7.1
evaluation_of
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s4-r24-t4.1-t3.1
interacts_with
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s4-r25-t6.1-t5.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s4-r26-t4.1-t6.1
affects
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s4-r27-t7.1-t1.1
issue_in
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s4-r28-t2.1-t5.1
evaluation_of
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s4-r29-t6.1-t2.1
associated_with
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s4-r30-t5.1-t7.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s4-r31-t3.1-t5.1
affects
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s4-r32-t3.1-t2.1
diagnoses
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s4-r33-t4.1-t5.1
affects
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s4-r34-t2.1-t1.1
issue_in
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s5-r1-t1.1-t2.1
location_of
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s6-r1-t3.1-t5.2
connected_to
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s6-r2-t2.1-t5.1
surrounds
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s6-r3-t5.2-t3.1
connected_to
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s6-r4-t4.1-t5.2
produces
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s6-r5-t4.1-t1.1
degree_of
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s6-r6-t5.2-t2.1
connected_to
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s6-r7-t2.1-t4.1
location_of
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s6-r8-t5.1-t2.1
developmental_form_of
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s6-r9-t2.1-t5.2
connected_to
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s6-r10-t3.1-t4.1
location_of
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s6-r11-t1.1-t5.2
produces
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s6-r12-t4.1-t1.1
associated_with
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s6-r13-t1.1-t4.1
degree_of
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s6-r14-t5.2-t4.1
causes
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s6-r15-t2.1-t1.1
location_of
DerAnaesthesist.50440291.ger.abstr-s8-t2
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s6-r16-t4.1-t5.2
occurs_in
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s6-r17-t5.2-t1.1
causes
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s6-r18-t3.1-t5.1
surrounds
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s6-r19-t5.1-t5.2
surrounds
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s6-r20-t5.1-t4.1
location_of
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s6-r21-t3.1-t1.1
location_of
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s6-r22-t4.1-t5.1
produces
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s6-r23-t1.1-t5.2
occurs_in
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s6-r24-t5.1-t3.1
developmental_form_of
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s6-r25-t1.1-t4.1
associated_with
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s6-r26-t5.1-t1.1
location_of
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s6-r27-t5.2-t5.1
derivative_of
DerAnaesthesist.50440291.ger.abstr-s6-t5
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s7-r1-t4.1-t9.1
location_of
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s7-t9
DerAnaesthesist.50440291.ger.abstr-s7-r2-t3.1-t8.1
associated_with
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-t8
DerAnaesthesist.50440291.ger.abstr-s7-r3-t4.1-t8.1
location_of
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s7-t8
DerAnaesthesist.50440291.ger.abstr-s7-r4-t3.1-t7.1
associated_with
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s7-r5-t3.1-t9.1
evaluation_of
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-t9
DerAnaesthesist.50440291.ger.abstr-s7-r6-t9.1-t7.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t9
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s7-r7-t3.1-t5.1
associated_with
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s7-r8-t4.1-t7.1
location_of
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s7-t7
DerAnaesthesist.50440291.ger.abstr-s7-r9-t6.1-t9.1
measurement_of
DerAnaesthesist.50440291.ger.abstr-s7-t6
DerAnaesthesist.50440291.ger.abstr-s7-t9
DerAnaesthesist.50440291.ger.abstr-s7-r10-t3.1-t1.1
associated_with
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s7-r11-t4.1-t5.1
location_of
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s7-r12-t9.1-t5.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t9
DerAnaesthesist.50440291.ger.abstr-s7-t5
DerAnaesthesist.50440291.ger.abstr-s7-r13-t9.1-t8.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t9
DerAnaesthesist.50440291.ger.abstr-s7-t8
DerAnaesthesist.50440291.ger.abstr-s7-r14-t4.1-t3.1
location_of
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-r15-t9.1-t3.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t9
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s7-r16-t4.1-t1.1
location_of
DerAnaesthesist.50440291.ger.abstr-s7-t4
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s7-r17-t9.1-t1.1
result_of
DerAnaesthesist.50440291.ger.abstr-s7-t9
DerAnaesthesist.50440291.ger.abstr-s9-t1
DerAnaesthesist.50440291.ger.abstr-s8-r1-t3.1-t1.1
occurs_in
DerAnaesthesist.50440291.ger.abstr-s8-t3
DerAnaesthesist.50440291.ger.abstr-s9-t1