Nervenschäden bei Regionalanästhesie – Nervenschäden bei peripheren Blockaden: Klinik und Inzidenz

Zusammenfassung

Bleibende Nervenschäden im Rahmen peripherer Nervenblockaden sind eine Rarität. Häufig treten die Beschwerden kombiniert auf und bessern sich noch während des Krankenhausaufenthalts. In den bisherigen Studien wurden neurologische Dysfunktionen unterschiedlich definiert, wodurch die Angaben zur Inzidenz variieren. Interskalenäre Blockaden scheinen unter den verschiedenen Lokalisationen die höchste Inzidenz aufzuweisen. Die Dysfunktionen äußern sich in Parästhesien, Taubheit, Störungen im Berührungsempfinden und/oder Muskelschwäche. Eine Reduzierung neurologischer Beschwerden durch ultraschallgestützte Blockaden konnte durch bisherige Daten nicht gezeigt werden. Patientenbezogene Risikofaktoren, extreme Lagerungen während der Operation und andere Ursachen machen es oft schwierig, einen Zusammenhang zwischen den Beschwerden und den stattgehabten Blockaden zu finden. Dennoch zählen durch Blockaden hervorgerufene Nervenschäden zu den seltenen anästhesiebezogenen Zwischenfällen.

Abstract

Persistent nerve injuries in context of peripheral nerve blocks are uncommon. Previous surveys and prospectively designed studies have specified neurological dysfunctions in different ways, which may cause the variability of data about incidence; so it has to be reckoned with about 5% after 1 week, 1% after 1 month and 0,01% after 6 months. Amongst the different locations interscalene blocks with their associated surgical procedures seem to have the highest incidence. Establishing the correlation between disabilities and the performed block technique often constitutes difficulties, especially when other reasons like patient positioning techniques, tractions, ischemia and surgery related nerve injuries have to be considered. Dysfunctions manifest as numbness, parasthesia, tingling sensation and/or amyasthenia. Fortunately long-term lesions, caused by nerve blocks are a rarity.

Schlüsselwörter:

periphere Nervenschäden - Klinik - Inzidenz

Key words:

peripheral nerve injuries - clinic - incidence

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