Prophylaxe des geburtshilflichen Säureaspirationssyndroms in der Bundesrepublik Deutschland 1997

H. Schneck; B. v Hundelshausen; R. Wagner; M. Scheller; E. Kochs

doi:10.1055/s-1999-10833

AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, Table of Contents

Anästhesiol Intensivmed Notfallmed Schmerzther 1999; 34(4): 204-213
DOI: 10.1055/s-1999-10833

ORIGINALIA

Georg Thieme Verlag Stuttgart · New York

Prophylaxe des geburtshilflichen Säureaspirationssyndroms in der Bundesrepublik Deutschland 1997

Eine Bestandsaufnahme anhand der Ergebnisse einer bundesweiten UmfrageProphylactic Measures Against Obstetric Acid Aspiration Syndrome in the Federal Republic of Germany 1997. A Review Based on the Results of a Federal Survey. H. Schneck, B. v. Hundelshausen, R. Wagner, M. Scheller, E. Kochs

Institut für Anaesthesiologie der Technischen Universität München, Klinikum rechts der Isar (Direktor: Univ.-Prof. Dr. E. Kochs)

Abstract

Zusammenfassung.

In einer Fragebogenaktion wurden die LeiterInnen der Anästhesieabteilungen von 1061 deutschen Kliniken mit geburtshilflicher Abteilung angeschrieben und nach dem routinemäßigen Vorgehen zur Prophylaxe des Säureaspirationssyndroms (SAS) bei Schwangeren und bei geburtshilflichen Eingriffen befragt (Methoden zur Verhinderung einer Aspiration durch Lagerung, Sellick-Handgriff, Verringerung des Mageninhalts bzw. zur Abmilderung der Konsequenzen einer Aspiration auf medikamentösem Wege). Bei hohem Rücklauf (82 %) wurden dabei fast 700 000 Geburten einschließlich nahezu 115 000 Sectiones erfaßt. Vor der Anästhesie bei Schwangeren wird in 36 Prozent routinemäßig eine Prophylaxe des SAS durchgeführt, meist ab etwa der 20. Schwangerschaftswoche. Prophylaxemaßnahmen bei vaginaler Geburt sind selten (7 %). Bei elektiver (dringlicher) Sectio führen vor Allgemeinanästhesie 93 % (94 %) der Kliniken, vor Regionalanästhesie 52 % (52 %) eine SAS-Prophylaxe durch. Bei anderen geburtshilflichen Eingriffen (z. B. Nachräumung) werden regelmäßig Maßnahmen der SAS-Prophylaxe vor Allgemeinanästhesie in 77 %, vor Regionalanästhesie in 23 % getroffen.

A survey of all German hospitals providing obstetric anesthesia was performed in 1997 (n = 1061, recovery rate 82 %; comprising about 700 000 deliveries and 115 000 cesareans, resp.) concerning the routine prophylactic measures for acid aspiration syndrome (AAS) in pregnant patients and before obstetric procedures (i. e., prevention of aspiration by positioning, Sellick's manoeuvre, reduction of intragastric volume, or reduction of gastric content acidity). In pregnant patients, any prophylaxis of AAS is performed in 36 %. Of the patients expecting delivery in the labour ward, only 7 % receive pharmacological AAS treatment. Before scheduled (urgent, non-emergency) cesarean section in general anesthesia, 93 % (94 %) of patients receive prophylactic treatment, either pharmacological or non-pharmacological. Before regional anesthesia, the corresponding numbers are 52 % for both scheduled or urgent CS.

Schlüsselwörter:

Anästhesie - geburtshilfliche - Säureaspiration - Aspiration - Natriumzitrat - H₂-Blocker - Metoclopramid - Sectio caesarea - Schwangerschaft

Key words:

Anesthesia obstetric - Acid aspiration syndrome - Aspiration - Sodium citrate - H2 blocker - Metoclopramide - Cesarean section - Pregnancy

Full Text

References

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Prof. Dr. Hajo Schneck

Institut für Anaesthesiologie der Technischen Universität München

Klinikum rechts der Isar

Ismaninger Straße 22

D-81675 München