Little is known about the specific anaesthesiological and multidisciplinary management of high-intensity focused ultrasound (HIFU) in uterine fibroids. This observational single-center study is the first reporting on an interdisciplinary approach to optimize outcome following ultrasound (US)-guided HIFU in German-speaking countries. A sample of forty patients with symptomatic uterine fibroids was treated by HIFU. Relevant treatment parameters such as total treatment time for intervention, anaesthesia, and sonication time as well as total energy, body temperature, peri-interventional medication and complications were analyzed. Interventional variables did not correlate significantly either with opioid dose or with body temperature. The average fibroid volume reduction rate was 37.8% ± 23.5%, 48.5% ± 22.0% and 70.2% ± 25.5% after 3, 6 and 12 months, respectively. No major anaesthesiological complications occurred apart from an epileptic seizure prior to HIFU treatment in one patient. Peri-procedural hyperthermia (> 37.5 °C) occurred in two patients. Post-procedural two patients experienced a sciatic nerve irritation up to one year; one patient with very large treated fibroid experienced strong short-lasting post-procedural pain. There were two complication-free pregnancies of HIFU-treated patients. Multidisciplinary management is crucial to optimize safety and outcome of US-guided HIFU for uterine fibroids. Peri-procedural pain and temperature management are critical points where an adequate collaboration between anesthesiologist and interventionalist is mandatory.

ZusammenfassungAktuell wird der Nationale Kompetenzbasierte Lernzielkatalog Medizin auf Grundlage des „Masterplan Medizinstudium 2020“ weiterentwickelt. Er soll mit Inkrafttreten der neuen Ärztlichen Approbationsordnung verpflichtend an allen medizinischen Fakultäten umgesetzt werden. Im Mittelpunkt steht die Frage, welche Kompetenzen der ärztliche Nachwuchs im Rahmen des Kerncurriculums ihres Medizinstudiums erwerben sollte. In diesem Rahmen sollen auch neue kompetenzbasierte Lehrformate in das Medizinstudium integriert werden. Ein essenzieller Bestandteil sind dabei neue Prüfungsformate, die das aktuelle Format der Multiple-Choice-Questions (MCQ) in Zukunft ablösen werden.