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Erschienen in: HNO 1/2008

01.01.2008 | Originalien

Steroide zur Reduktion der Morbidität nach Tonsillektomie

verfasst von: Dr. J. P. Windfuhr

Erschienen in: HNO | Ausgabe 1/2008

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Zusammenfassung

Hintergrund

Übelkeit, Erbrechen, Schmerzen und verzögerte Nahrungsaufnahme kennzeichnen im Wesentlichen die Morbidität nach Tonsillektomie. Neben verschiedenen anderen Maßnahmen ist es in der Vergangenheit gelungen, die postoperative Morbidität durch Steroidgabe positiv zu beeinflussen.

Patienten und Methoden

Die Allgemeingültigkeit von Empfehlungen zur Steroidgabe nach Tonsillektomie soll mittels Literaturrecherche überprüft werden. Ausgeschlossen sind Studien, in denen Steroide mit anderen Medikamenten zur Reduzierung der postoperativen Morbidität verglichen wurden.

Ergebnisse

Die insgesamt 31 Studien sind hinsichtlich Altersverteilung, Operationsmethoden, Nachbeobachtungszeit und Anästhesieverfahren sehr heterogen und nicht frei von Einflussfaktoren. Zwei Drittel der Untersuchungen konnten einen zeitlich befristeten analgetischen Effekt nachweisen, die Hälfte beobachtete bei den Messkriterien Übelkeit, Erbrechen oder Kostaufbau jeweils einen positiven Effekt. Nur 15 Studien untersuchten jedoch sämtliche Messkriterien.

Schlussfolgerungen

Die vorliegenden Daten sprechen insgesamt dafür, dass Übelkeit, Erbrechen und Dauer des Kostaufbaus durch präoperative Steroidgabe signifikant zu reduzieren sind. Tendenziell gilt dies auch für den analgetischen Effekt. Zur abschließenden Bewertung sind jedoch noch weitere Studien notwendig. Hierbei muss auf die Elimination multipler Einflussfaktoren geachtet werden.
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Metadaten
Titel
Steroide zur Reduktion der Morbidität nach Tonsillektomie
verfasst von
Dr. J. P. Windfuhr
Publikationsdatum
01.01.2008
Verlag
Springer-Verlag
Erschienen in
HNO / Ausgabe 1/2008
Print ISSN: 0017-6192
Elektronische ISSN: 1433-0458
DOI
https://doi.org/10.1007/s00106-007-1550-8

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Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

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Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

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