Perioperatives Management von Rheumapatienten

Abstract

Background

Patients with inflammatoric rheumatic diseases show an elevated risk for complications following surgery.

Material and methods

There are updated recommondations of the German Society of Rheumatology for the perioperative treatment of patients with inflammatory rheumatic diseases.

Results and Conclusions

The perioperative risk is multifactorial. It is not clear, if bDMARDs or tsDMARDs elevate the peri-operative risk. Under bDMARDs surgery can be done at the end of the treatment interval. Glucocorticoids elevate the risk for infection and should be reduced to the lowest dose possible and then should be kept on a constant level (<10 mg/d). Usually csDMARDs (e.g. Methotrexat) can be continued. Small molecules should be paused for 3–4 days. The peri-operative treatment remains an individual decision for each patient.