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In der anasthesiologischen und intensivmedizinischen Praxis werden in zunehmendem Mas auch Patienten mit implantierten Medikamentenpumpen behandelt. Grundkenntnisse uber die Besonderheiten dieser Therapiemethode sind deshalb wichtig. Im Rahmen der praanasthesiologischen Visite mussen Informationen uber die Pumpe, den intrathekalen Katheter, Art und Dosierung der applizierten Medikamente sowie der nachste Befulltermin erfragt und dokumentiert werden. Punktionen im Bereich der Pumpe und des Katheterverlaufs mussen vermieden werden. Im Rahmen der intensivmedizinischen Betreuung mussen Wechselwirkungen sowie Uber- oder Unterdosierungen der intrathekal verabreichten Medikamente bedacht werden. Die Kenntnis der Befulltermine und die rechtzeitige Organisation der Befullung sind wesentlich, um Komplikationen zu vermeiden.

Background Brachytherapy presents the anaesthetist with unique problems. Information on anaesthesia for brachytherapy, however, is limited. The aim of this paper is to report on our experience involving a large number of brachytherapy procedures. Methods A retrospective analysis of records of 1622 anaesthetic procedures in 952 patients is presented. Records were analysed in respect of patient data, tumour localization, brachytherapy treatment and the type and duration of anaesthetic procedures. Results More than one-third of patients were at high risk (ASA III or IV) and 40% were more than 60 yr. Repetitive treatments were performed on half of the patients. Breast cancer was the most common indication. The average duration of anaesthesia for pelvic brachytherapy was more than 3 h, with a high degree of variability. Regional anaesthesia was used in 30% of all cases and was the predominant technique for pelvic brachytherapy. Spinal catheter techniques represented a high proportion of those receiving regional anaesthesia. Complications resulting from regional and general anaesthesia were minor and no serious incidents occurred. Conclusions Based on a large number of procedures, this study gives an example of anaesthetic management in brachytherapy. A substantial minority of patients would be considered high risk for surgical intervention. Regional anaesthesia was the principal technique used when dealing with tumours of the lower body.