Zusammenfassung
Die klassische Technik der Rapid Sequence Induction (RSI) ist eine fundamentale Form
der Anästhesieeinleitung bei nicht nüchternen Patienten zur Verhinderung der Aspiration
von Mageninhalt. Schwangere und Kinder sind aufgrund ihrer Hypoxiegefährdung eine
besondere Herausforderung; das klassische RSI-Konzept „Induktion – Apnoe – (Krikoiddruck
–) Intubation“ muss bei ihnen zugunsten einer kontrollierten Technik mit Erhalt der
Oxygenierung modifiziert werden.
Abstract
Aspiration during anesthesia induction is no triviality, but can lead to serious complications
and mortality. The classic technique of rapid sequence induction (RSI) is a fundamental
form of anesthesia induction in non-fasting patients to prevent pulmonary aspiration
of gastric contents.
Pregnant women and children pose a special challenge due to their hypoxia risk; the
classical RSI concept “induction – apnea – (cricoid pressure –) intubation” can lead
to hypoxia and therefore must be modified in favor of a controlled technique with
preservation of oxygenation in this patient group. A controlled procedure with continuous
oxygenation as far as possible should be used.
The preparation of an RSI involves the careful selection of medicines, equipment and
monitoring. An important quality criterion of RSI is the atraumatic airway management
in deep anesthesia with profound muscle relaxation without resistance (coughing, choking,
pressing) of the patient.
Schlüsselwörter
Kinderanästhesie - Anästhesie in der Geburtshilfe - pulmonale Aspiration - Rapid Sequence
Induction
Key words
pediatric anesthesia - obstetric anesthesia - pulmonary aspiration - rapid sequence
induction
