Lagerungsschäden beim Patienten mit unbekanntem „thoracic outlet syndrome”

Peterson, Tracy S.; Wissing, H.

doi:10.1055/s-2007-996544

Cited by 7 publications

(8 citation statements)

References 1 publication

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“…VI ZR 60/ 94; VersR 1995, 539) is not contrary to the obligation to inform the patient of the possible risk of positioning injuries [16,17], because even technically perfect positioning cannot prevent pressure injury. In the above ruling of January 24,1984, in which the BGH referred the procedure back to the appeals court for a fresh ruling, the BGH indicated that the appeals court would also have to investigate the issue "whether the consent to the operation given by the plaintiff could be invalid because of insufficient information about the risk of positioning injuries." Accordingly, most currently available commercial information and medical history sheets include the risk of positioning injury as part of the information provided to patients [18].…”

Section: 2mentioning

confidence: 99%

“…Neuropathy, pressure ulcer Age > 70 years [20] Neuropathy, pressure ulcer Malnutrition [22] Pressure ulcer Peripheral arterial occlusive disease Neuropathy Smoking and COPD [12,22,23] Neuropathy of the lower extremities, pressure ulcer Anatomical abnormality (cervical rib, etc.) [24] Neuropathy Pre-existing neuropathies [12] Neuropathy, pressure ulcer Table 3 Surgical factors associated with an increased risk of positioning injury.…”

Section: Positioning-related Neuropathiesmentioning

confidence: 99%

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The Prevention of Positioning Injuries during Gynecologic Operations. Guideline of DGGG (S1-Level, AWMF Registry No. 015/077, February 2015)

Fleisch

Bremerich

Schulte‐Mattler

et al. 2015

Geburtshilfe Frauenheilkd

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!Purpose: Official guideline published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). Positioning injuries after lengthy gynecological procedures are rare, but the associated complications can be potentially serious for patients. Moreover, such injuries often lead to claims of malpractice and negligence requiring detailed medical investigation. To date, there are no binding evidence-based recommendations for the prevention of such injuries. Methods: This S1-guideline is the work of an interdisciplinary group of experts from a range of different professions who were commissioned by DGGG to carry out a systematic literature search of positioning injuries. Members of the participating scientific societies develop a consensus in an informal procedure. Afterwards the directorate of the scientific society approves the consensus. The recommendations cover: " responsibility, information provided to the patient, documentation " basic principles to prevent positioning injuries " prevention of specific types of positioning injuries such as injuries " of the upper extremities " of the lower extremities " injuries caused by high-frequency surgery " pressure ulcers caused by positioning " prevention of compartment syndrome " clinical monitoring and the diagnosis of positioning injuries

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Section: 2mentioning

confidence: 99%

Section: Positioning-related Neuropathiesmentioning

confidence: 99%

The Prevention of Positioning Injuries during Gynecologic Operations. Guideline of DGGG (S1-Level, AWMF Registry No. 015/077, February 2015)

Fleisch

Bremerich

Schulte‐Mattler

et al. 2015

Geburtshilfe Frauenheilkd

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“…Vermutet man eine Nervenschädigung, wird eine klinische und elektrophysiologische Untersuchung durch einen Neurologen veranlasst. Nicht ganz selten lassen sich retrospektiv anatomische Varianten oder präexistente Neuropathien als Mit− verursacher eruieren [16,26].…”

Section: Schlussbemerkungunclassified

“…Zwar lassen sich lagerungsabhängige Störungen der Durchblu− tung bei bestimmten Syndromen durch Provokationstests erfas− sen. So führt beim Thoracic−outlet−Syndrom die Hyperextension des Kopfes mit Seitwärtsdrehen des Kinns zur kranken Seite (Ad− son−Manöver) neben Sensibilitätsstörungen zu einer Kompres− sion der A. subclavia mit Abschwächung des Radialispulses[26]. Ähnliche Symptome lassen sich beim Hyperabduktions−Syn− drom durch Hochheben des Armes über die Waagerechte auslö− sen. Hier würde sich die ¹Über−Kopf"−Lagerung des Patientenar− mes verbieten.…”

unclassified

Lagerungsschäden aus der Sicht des Anästhesisten

Bund

Heine²,

Jaeger³

2005

Anasthesiol Intensivmed Notfal

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Anaesthetist and surgeon cooperate in positioning the patient for surgery according to interdisciplinary agreements. The legal demands on documentation for standard positioning procedures are met with a symbol or short notice on the anaesthesia protocol. In the case of damage to the patient, however, the doctor has to furnish evidence that the patient has been positioned correctly. Complications associated with perioperative patient positioning are reported to be 1 to 1000. Peripheral nerves are at highest risk, but soft tissue, joint, vascular and ocular damages are also reported. The problems and adequate care of different positioning modes, such as recumbent, lateral, prone, seated and lithotomy position, are discussed in detail.

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“…Alternativ zur SPA für Eingriffe in Bauchlage werden die Periduralanäs-lich 4 Personen, der zur Umlagerung von intubierten Patienten in die Bauchlagerung notwendig ist, sind hierbei auch kardiozirkulatorische Nebenwirkungen [3] und in Einzelfällen sogar respiratorische Probleme beschrieben worden [4,39] [35]. Es gibt zur Inzidenz von Nervenschäden nach Bauchlagerung in der Literatur trotz einiger guter Übersichtsartikel [24,47] keine genaue Zahlen, und es ist zu befürchten, daß eine relativ hohe Dunkelziffer an unerkannten oder passageren nervalen Beeinträchtigungen existiert.…”

Section: Ist Die Periduralanästhesie Eine Alternative?unclassified

Ist die Spinalanästhesie bei Eingriffen in Bauchlage ein empfehlenswertes Verfahren?

1999

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There is still controversy on the usefulness of spinal anesthesia for operations performed in the prone or jackknife position. There is about the risk of inadvertent increase of the sensomotory blockade with the patient in the prone position and the difficulty of managing consecutive cardiorespiratory complications or inducing general anesthesia in case of failures. This article reviews the current literature in terms of safety and effectiveness of spinal anesthesia for such operations. For lower-limb or perianal operations with limited extension and blood loss, performed in the prone position, spinal anesthesia seems to be a safe, effective and economic technique in patients without severe a cardiac history. Substantial knowledge about the onset time, fixation time, duration of sensomotory block and baricity of the applied local anesthetic is crucial in this setting. Obese patients are at risk for sudden extension of the block when turned into the prone position. Additional narcotics and sedatives should be avoided and continuous monitoring of hemodynamic and respiratory parameters, of the level of the blockade and vigilance of the patient is mandatory.

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Lagerungsschäden beim Patienten mit unbekanntem „thoracic outlet syndrome”

Cited by 7 publications

References 1 publication

The Prevention of Positioning Injuries during Gynecologic Operations. Guideline of DGGG (S1-Level, AWMF Registry No. 015/077, February 2015)

The Prevention of Positioning Injuries during Gynecologic Operations. Guideline of DGGG (S1-Level, AWMF Registry No. 015/077, February 2015)

Lagerungsschäden aus der Sicht des Anästhesisten

Ist die Spinalanästhesie bei Eingriffen in Bauchlage ein empfehlenswertes Verfahren?

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