Das Edelgas Xenon - Ein ideales Anästhetikum?

Zusammenfassung

Das Edelgas Xenon besitzt neben seiner anästhetischen und analgetischen Wirkung viele Eigenschaften eines idealen Anästhetikums. Seine Anwendung in der klinischen Praxis ist jedoch durch seine extrem hohen Herstellungskosten limitiert. Neuere Studien haben neben bekannten Vorteilen wie hoher hämodynamischer Stabilität und schnellem Erwachen aus der Anästhesie zusätzlich Hinweise auf organoprotektive Effekte bei gleichzeitigem Fehlen relevanter Nebenwirkungen ergeben. Damit könnte Xenon insbesondere bei Risikopatienten bzw. spezifischen Eingriffen möglicherweise Vorteile gegenüber anderen Anästhetika aufweisen, die seinen Einsatz in der klinischen Praxis sinnvoll erscheinen lassen.

Abstract

The noble gas xenon, besides its anaesthetic and analgesic properties, shows many characteristics of an ideal anaesthetic agent. However, due to high production costs, its application is limited In daily clinical routine. Recent studies suggested not only outstanding haemodynamic stability and rapid emergence from anaesthesia, but also xenon's capacity to mediate protection against ischaemic damage in various organs and tissues. Since xenon is devoid of toxicity and relevant side effects, it could be beneficial at least in a subset of patients at high risk, and xenon therefore may become a reasonable alternative in this patient population.

Schlüsselwörter:

Edelgas - Xenon - Anästhesie - Organprotektion - Risikopatienten

Key words:

noble gas - xenon - anaesthesia - organ protection - perioperative risk

Kernaussagen

• Xenon kommt in der Summe seiner Eigenschaften dem idealen Anästhetikum im Vergleich zu anderen Anästhetika bisher am nächsten.

• Xenon scheint für kardiovaskuläre Risikopatienten besonders geeignet zu sein, weil es die hämodynamische Stabilität fördert und den Sympathikotonus reduziert.

• Von den neuroprotektiven Eigenschaften des Xenons könnten Patienten mit einem hohen Risiko für neurokognitive Defizite profitieren.

• Hohe Kosten limitieren den Einsatz von Xenon auf spezielle Indikationen und Risikopatienten.

• Geeignete Anästhesiegeräte und Recycling-Verfahren sind Voraussetzung für den in Zukunft breiteren Einsatz von Xenon in der klinischen Praxis.

• Klinisch relevante Vorteile des Xenons gegenüber anderen Anästhetika müssen durch große, multizentrische Studien weiter evaluiert werden.

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