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Anästhesiol Intensivmed Notfallmed Schmerzther 2011; 46(10): 640-646
DOI: 10.1055/s-0031-1291941
Fachwissen
Anästhesie
© Georg Thieme Verlag Stuttgart · New York

Kreißende mit Substanzkonsum – Bedeutung in der geburtshilflichen Anästhesie

Anesthesiological management of the drug-abusing parturient. Relevance of maternal substance abuse for obstetric anesthesia.
Felix Kork
,
Robin Kleinwächter
,
Lutz Kaufner
,
Edith Weiß-Gerlach
,
Jan-Peter Siedentopf
,
Claudia Spies
Further Information

Publication History

Publication Date:
21 October 2011 (online)

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Die meisten weiblichen Konsumenten legaler und illegaler psychotroper Substanzen sind in gebärfähigem Alter. Die Übergänge von gelegentlichem Konsum zu schädlichen Konsum und zum Abhängigkeitssyndrom sind dabei fließend. Viele junge Frauen stellen zu Beginn der Familienplanung oder spätestens nach Kenntnis der Schwangerschaft den Konsum dieser Substanzen ein. Gelingt dies nicht, erfordert die Betreuung dieser sehr komplexen und individuellen Fälle eine gute interdisziplinäre Zusammenarbeit.

Most of the female consumers of legal and illegal substances are of childbearing age. Occasional use, use disorder and addiction commonly devolve into each other. A lot of young women quit consuming when planning a family or at the latest with the knowledge of pregnancy. The ongoing substance abuse during pregnancy requires a coordinated interdisciplinary collaboration for a sufficient care of these highly complex and individual cases.

Kernaussagen

  • Substanzgebrauch bleibt im Prämedikationsgespräch häufig unentdeckt.

  • Die peripartale Behandlung substanzabhängiger Schwangerer sollte in enger und intensiver Zusammenarbeit zwischen Geburtshilfe, Psychiatrie, Anästhesie, Neonatologie und dem sozialmedizinischen Dienst erfolgen.

  • Viele substanzabhängige Schwangere leiden an mehr oder weniger ausgeprägten, nicht diagnostizierten und nicht therapierten Persönlichkeitsstörungen und anderen psychiatrischen Erkrankungen.

  • Nahezu alle Arten von Substanzmissbrauch sind mit einer erhöhten peripartalen Komplikations- und Sektio-Rate assoziiert.

  • Nach Schnittentbindungen in Regionalanästhesie hat es sich bewährt, den Periduralkatheter für die postoperative Schmerztherapie zu belassen.

  • Nach Allgemeinanästhesien zur Schnittentbindung ohne Regionalverfahren hat sich das intraoperative Infiltrieren der Wunde mit langwirksamen Lokalanästhetika als günstig erwiesen.

Schlüsselwörter:

Drogen - Missbrauch - Schwangerschaft - Entzug - Neugeborene

Key words:

Drugs - abuse - pregnancy - withdrawal - neonate

Ergänzendes Material

 

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