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Laryngorhinootologie 2015; 94(08): 516-523
DOI: 10.1055/s-0035-1549926
Positionspapier
© Georg Thieme Verlag KG Stuttgart · New York

Positionspapier zum perioperativen Management von erwachsenen Patienten mit obstruktiver Schlafapnoe bei HNO-ärztlichen Eingriffen

Position Paper: Perioperative Management of Adult Patients with Obstructive Sleep Apnea in ENT Surgery
M. Rösslein
1   Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Freiburg
,
H. Bürkle
1   Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Freiburg
,
A. Walther
2   Klinik für Anästhesiologie und operative Intensivmedizin, Katharinenhospital, Klinikum Stuttgart
,
B. A. Stuck
3   Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Essen
,
T. Verse
4   Abteilung für HNO-Heilkunde, Kopf- und Halschirurgie, Asklepios Klinikum Harburg
› Author Affiliations
Further Information

Publication History

Publication Date:
04 August 2015 (online)

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Zusammenfassung

Die obstruktive Schlafapnoe (OSA) ist eine im Schlaf auftretende Atmungsstörung mit zunehmender Prävalenz, bei der es trotz fortbestehender Atemanstrengung zu einer sich wiederholenden, teilweisen oder vollständigen Verlegung des pharyngealen Atemweges kommt. In Abhängigkeit vom Schweregrad der Erkrankung kann dies zu Schlafunterbrechungen, einer Gasaustauschstörung sowie kardiovaskulären und metabolischen Folgeerkrankungen führen.

Chirurgische Patienten mit einer OSA, welche präoperativ in den meisten Fällen nicht diagnostiziert ist, haben ein erhöhtes Risiko für das perioperative Auftreten von pulmonalen, kardiovaskulären und weiteren Komplikationen.

Spezielle Maßnahmen können dazu beitragen, die Sicherheit der Patienten in dieser Phase zu erhöhen. Dazu zählen präoperativ die frühzeitige Erkennung und Einschätzung einer OSA und eventuell bestehender Begleiterkrankungen, intraoperativ die Auswahl eines geeigneten Anästhesie- und Überwachungsverfahrens sowie postoperativ die Aufrechterhaltung einer ausreichend langen Überwachungsdauer mit der Möglichkeit intensivmedizinischer Behandlungsmaßnahmen. Das konkrete Vorgehen sollte sich dabei nach dem individuellen Risikoprofil des einzelnen Patienten richten, das u. a. vom Schweregrad der OSA, der Invasivität des operativen Eingriffes und vom postoperativen Opioidbedarf sowie dem Auftreten kritischer Ereignisse in der frühen postoperativen Phase abhängt.

Auf Initiative und im Auftrag der Deutschen Gesellschaft für Hals-, Nasen-, Ohren-Heilkunde, Kopf- und Hals-Chirurgie sollen nachfolgend auf der Grundlage der bestehenden Literatur und bereits existierender Leitlinien anderer Fachgesellschaften Empfehlungen für das perioperative Management von erwachsenen Patienten mit OSA bei HNO-ärztlichen Eingriffen vorgestellt werden.

Schlüsselwörter

Obstruktive Schlafapnoe - perioperative Komplikationen - perioperatives Management

Key words

obstructive sleep apnea - perioperative complications - perioperative management
 

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