{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:44:48Z","timestamp":1760489088283,"version":"build-2065373602"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2025,2]]},"abstract":"Zusammenfassung<\/jats:title>\n Hintergrund Handchirurgische Operationen werden im besonderen Ma\u00dfe\n zunehmend in den ambulanten Sektor gedr\u00e4ngt. Die postoperative\n Schmerzmittelversorgung orientiert sich empirisch an der Schmerzhaftigkeit\n einzelner Eingriffe, ohne dass diese systematisch untersucht worden w\u00e4re.<\/jats:p>\n Patienten und Methoden Die postoperative Schmerzhaftigkeit (visuelle\n Analogskala) von 722 Operationen an Hand- und Handgelenk (01.07.2021 bis\n 30.06.2023) wurde bis Tag 5 erfasst. Die Analgetikagabe erfolgte empirisch und\n nach dem WHO-Stufenschema. Prim\u00e4rer Endpunkt waren Schmerzen nach Gelenk- oder\n Knochenoperationen an Tag 1 verglichen mit Weichteil-, endoskopischen Eingriffen\n oder Materialentfernungen. Sekund\u00e4re Endpunkte waren Schmerzen in Abh\u00e4ngigkeit\n von Geschlecht, Alter, Operationsdauer und vorheriger Schmerzmitteleinnahme.<\/jats:p>\n Ergebnisse Operationen an Knochen und Gelenken gingen mit signifikant\n (p<0,001) st\u00e4rkeren Schmerzen (5,42\u00b12,8) einher als andere Operationen\n (3,47\u00b12,6). Weibliches Geschlecht (p=0,001), l\u00e4ngere Operationsdauer (R>0,2)\n und j\u00fcngeres Alter (R>0,2) korrelierten schwach mit st\u00e4rkeren Schmerzen,\n w\u00e4hrend vorherige Opioideinnahme m\u00e4\u00dfig mit erh\u00f6htem Opioidbedarf (R=0,34)\n postoperativ einhergingen. Insgesamt verringerten sich die Schmerzen vom\n Operationsabend (4,4\u00b12,8) bis Tag 5 (3,7\u00b12,7; 2,8\u00b12,4; 2,1\u00b12,1; 1,6\u00b11,9;\n 1,3\u00b11,7) jeweils t\u00e4glich.<\/jats:p>\n Schlussfolgerung Die Daten geben eine wissenschaftlich fundierte\n Orientierung f\u00fcr die Schmerzmittelversorgung bei ambulanten Operationen an Hand\n oder Handgelenk. Dabei muss die teils breite Streuung des Schmerzempfindens auch\n bei vermeintlich kleinen Operationen beachtet werden.<\/jats:p>","DOI":"10.1055\/a-2436-9471","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T19:19:31Z","timestamp":1731525571000},"page":"23-31","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Schmerzen nach ambulanten Operationen an der Hand und\n am Handgelenk"],"prefix":"10.1055","volume":"57","author":[{"given":"Steffen","family":"L\u00f6w","sequence":"additional","affiliation":[{"name":"Praxis f\u00fcr Handchirurgie und Unfallchirurgie, Bad Mergentheim,\n Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d6znur","family":"Dervis","sequence":"additional","affiliation":[{"name":"OrthoTeam MainSpessart, Marktheidenfeld, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Kiesel","sequence":"additional","affiliation":[{"name":"Praxis f\u00fcr Handchirurgie und Unfallchirurgie, Bad Mergentheim,\n Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger C.","family":"Erne","sequence":"additional","affiliation":[{"name":"Handchirurgie, Aestheticum, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian Karl","family":"Spies","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Spital Langenthal, Langenthal,\n Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Unglaub","sequence":"additional","affiliation":[{"name":"Handchirurgie, Vulpiusklinik, Bad Rappenau, Germany"},{"name":"Medizinische Fakult\u00e4t Mannheim, Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,11,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1016\/j.jhsa.2018.02.026","article-title":"Opioid 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