Regionalanästhesie für den ambulanten Eingriff: Möglichkeiten und Risiken

Die Regionalanästhesie (RA) im ambulanten Bereich birgt sowohl Möglichkeiten als auch Risiken. Patient*innen fürchten oft Nervenschädigungen und das Wachsein während der Operation – aber gerade für Hochrisiko-Patient*innen kann die RA sicherere Konzepte bieten. Basierend auf Erfahrungen eines eigenständigen Operationszentrums mit vielen ambulanten Patient*innen diskutiert dieser Beitrag den Einsatz der RA und die assoziierten Chancen und Risiken.

Abstract

Regional anaesthesia (RA) in the ambulatory setting presents both opportunities and risks, especially in an economically challenging healthcare system. Patients tend to associate RA with the risk of neuronal damage, paralysis and the need to be awake during surgery. However, the risks beyond the rare complications and associated claims are more likely to be variable neuronal blockade effects and disadvantages in high-throughput OR management. The use of RA techniques in the outpatient setting requires experienced selection of suitable patients, consideration of pre-existing risks such as coagulopathies, rapid standard set-up procedures, ultrasound guidance to avoid vascular and nerve damage and good psychological counselling of patients. A clinic with many outpatient procedures can become even more efficient through higher throughput, pain-free and awake procedures without patient discomfort. RA also offers significantly safer approaches for high-risk patients. Based on the experience of a university outpatient clinic, this short review discusses the use of RA with its risks and opportunities.

Kernaussagen

• RAVs sind auch ambulant sichere Alternativen zur Allgemeinanästhesie mit geringerem postoperativem Analgetikabedarf und reduziertem Nebenwirkungsprofil.

• Die erfolgreiche Umsetzung von RAVs in ambulanten Zentren erfordert eine hohe Expertise der Anästhesist*innen.

• Durch eine bewusste Wahl des Lokalanästhetikums nach Rücksprache mit dem oder der Operateur*in kann die Zeit bis zur Entlassung deutlich verkürzt und die Patientenzufriedenheit gesteigert werden.

• Postoperative Schmerztherapie im Rahmen ambulanter Eingriffe kann durch verschiedene Regionalanästhesiemethoden unter Umständen einfacher zu handhaben sein.

• Die Compliance der Patient*innen ist maßgeblich für den Erfolg eines ambulanten OP-Zentrums.

Schlüsselwörter

Walking Spinal - Sattelblock - einseitige Spinalanästhesie - kontinuierliche ambulante Regionalanästhesie

Keywords

walking spinal - uni-lateral spinal anesthesia - catheter-based ambulatory regional techniques

Publication History

Article published online:
02 June 2025

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