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Journal Club AINS 2020; 09(01): 58-66
DOI: 10.1055/a-0984-4214
Leitlinien in der Praxis

Empfehlungen zur Verwendung von Opioiden bei Kindern während der perioperativen Versorgung

Jost Kaufmann
,
Michael Laschat
,
Marcel Poels
,
Robin Joppich
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Leitlinien und Handlungsempfehlungen sind ein wirksames Instrument zur Verbesserung der Patientensicherheit bei der Versorgung von Kindern sowie der Wahrnehmung der Kinderanästhesie als Bereich einer besonderen Expertise. Die US-amerikanische Society for Pediatric Anaesthesia (SPA) hat Grundregeln zur Verwendung von Opioiden bei Kindern während der perioperativen Versorgung als Empfehlungen veröffentlicht [1].
Kernaussagen

  • Eine wesentliche Aufgabe bei der perioperativen Versorgung von Kindern ist eine sichere und gute Schmerztherapie.

  • Es sind grundsätzlich alle Opioid-sparenden Maßnahmen zu ergreifen, die möglich sind. Dabei sind vor allem Regionalanästhesieverfahren, Nichtopioid-Analgetika in ausreichender Dosierung sowie nichtpharmakologische Methoden (nichtnutritives Saugen, Trinken und Nähe zu Bezugspersonen) wichtig.

  • Zwingend müssen altersgruppenspezifische pharmakologischen Besonderheiten bekannt sein; vor allem Dosierungen und Wirkdauer unterscheiden sich erheblich zwischen den Altersgruppen.

  • Besonders Kinder mit bedeutsamen Grunderkrankungen, aber auch alle anderen, müssen aufgrund von Sicherheitsaspekten nach klaren Regeln behandelt und lückenlos überwacht werden.

  • Eine Übertherapie ist sowohl zur Vermeidung von kurzfristigen Komplikationen als auch zur Prävention von Missbrauch sicher auszuschließen.

  • Dennoch sollen Opioide keinem Patienten unabhängig seines Alters vorenthalten werden, bei dem mit anderen Methoden keine ausreichende Schmerzfreiheit erreicht werden kann.



Publication History

Article published online:
20 March 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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