Schaffartzik Walter, Hachenberg Thomas, Rust Jörn, Neu Johann
Direktor der Klinik für Anästhe siologie, Intensivmedizin und Schmerztherapie, Unfallkrankenhaus Berlin, Ärztlicher Leiter des ukb und Vorsitzender der Schlichtungsstelle für Arzthaftpfl ichtfragen der norddeutschen Ärztekammern, Hannover. Walter.Schaff
Anasthesiol Intensivmed Notfallmed Schmerzther. 2011 Jan;46(1):40-5; quiz 46. doi: 10.1055/s-0030-1270558. Epub 2011 Jan 17.
Injuries caused by regional anaesthesia are the second most common reason for a patient to apply to the North German Arbitration Board. Part of the reported injuries are mild and transient, while others are severe and permanent, e.g. a paraplegia after regional anaesthesia. In the majority of the reported cases, the Arbitration Board did not find a medical error as cause of the injury. Nevertheless, every possible effort needs to be made to reduce the number and the severity of the injuries due to regional anaesthesia. In order to reach that goal, medical treatment has to be applied with the appropriate care, including the strict adherence to the height of puncture for epidural and spinal anaesthesia below the Conus medullaris and the use of assisting devices like nerve stimulator and ultrasound-guided puncture. Using these measures, the frequency of injuries caused by regional anaesthesia will be reduced.
区域麻醉引起的损伤是患者向德国北部仲裁委员会申请仲裁的第二大常见原因。报告的损伤中部分是轻微且短暂的，而其他的则是严重且永久性的，例如区域麻醉后发生截瘫。在大多数报告的案例中，仲裁委员会并未发现医疗失误是损伤的原因。然而，仍需尽一切可能努力减少区域麻醉所致损伤的数量和严重程度。为实现这一目标，必须以适当的护理进行医疗操作，包括严格遵守硬膜外和脊髓麻醉在脊髓圆锥以下的穿刺高度，以及使用神经刺激器和超声引导穿刺等辅助设备。采用这些措施，区域麻醉引起的损伤频率将会降低。
