Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Hipersensibilidad mitocondrial al sevoflurano: la farmacogenética y el papel de las sociedades científicas","authors":"Y. Hernández-Castillo, E. Ruiz-Pesini","doi":"10.1016/j.redar.2026.502197","DOIUrl":"10.1016/j.redar.2026.502197","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 8","pages":"Article 502197"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cambios dinámicos en la vena yugular interna durante la posición supina y la elevación pasiva de las piernas como predictores de hipotensión inducida por la anestesia espinal en los mayores: un estudio de precisión diagnóstica prospectivo","authors":"M. Younes Taha,&nbsp;M.A. Helmy,&nbsp;E.M. Mostafa,&nbsp;O. Asaad,&nbsp;N. Sameh Fahmy,&nbsp;M. Mohamed Mustafa","doi":"10.1016/j.redar.2026.502207","DOIUrl":"10.1016/j.redar.2026.502207","url":null,"abstract":"<div><h3>Background</h3><div>Spinal anesthesia-induced hypotension is common in elderly patients and is associated with serious complications, including myocardial ischemia, arrhythmias, acute heart failure, stroke, renal injury, and, in rare cases, perioperative blindness. Reliable predictors are needed to identify vulnerable patients before anesthesia induction. This study evaluated whether dynamic changes in internal jugular vein diameter and between supine and passive leg raising could predict spinal anesthesia-induced hypotension in elderly patients.</div></div><div><h3>Methods</h3><div>This prospective study was conducted at Cairo University hospitals after ethics approval and trial registration. Patients older than 65 years, classified as American Society of Anesthesiologists physical status I-II, scheduled for elective infraumbilical surgery under spinal anesthesia, were enrolled. Exclusion criteria included obesity, uncontrolled hypertension, reduced cardiac function, emergency surgery, and contraindications to spinal anesthesia. Baseline hemodynamics were recorded supine. Internal jugular vein diameter and cross-sectional area were measured by ultrasound in supine and passive leg raising positions. Spinal anesthesia was performed with hyperbaric bupivacaine and fentanyl. Hypotension was defined as mean arterial pressure less than 65<!--> <!-->mmHg or a reduction greater than 20% from baseline. Receiver operating characteristic analysis was used to evaluate predictive accuracy.</div></div><div><h3>Results</h3><div>Of 92 patients screened, 70 were analyzed. Spinal anesthesia-induced hypotension occurred in 42 patients (60%), with severe hypotension in 7 patients (10%). Patients who developed hypotension showed significantly greater reductions in mean arterial pressure compared with stable patients. Percentage changes in internal jugular vein diameter and cross-sectional area between supine and passive leg raising were significantly higher in hypotensive patients (<em>P</em> <!-->&lt;<!--> <!-->0.001). Receiver operating characteristic analysis demonstrated excellent predictive accuracy: a change in diameter greater than 11 percent yielded an area under the curve of 1.00 with 100% sensitivity and specificity, while a change in cross-sectional area greater than 21.5% achieved an area under the curve of 0.99 with 100% sensitivity and 93% specificity. Static measurements alone had poor predictive value.</div></div><div><h3>Conclusion</h3><div>Dynamic changes in internal jugular vein diameter and cross-sectional area during passive leg raising are reliable, noninvasive predictors of spinal anesthesia-induced hypotension in elderly patients. Incorporating internal jugular vein ultrasonography into routine preoperative assessment may enhance risk stratification and guide preventive strategies. Larger multicenter studies are warranted to confirm these findings and evaluate their impact on clinical outcomes.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 8","pages":"Article 502207"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149071968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anestesia general o anestesia local/sedación en la trombectomía mecánica: de la evidencia clínica al reto organizativo","authors":"M. Taboada,&nbsp;J. Fernández","doi":"10.1016/j.redar.2026.502070","DOIUrl":"10.1016/j.redar.2026.502070","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 8","pages":"Article 502070"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mascarilla Baska Mask® frente a mascarilla laríngea ProSeal™ para el sellado de la vía aérea y rendimiento clínico en cirugía laparoscópica ginecológica: un ensayo aleatorizado","authors":"M.G. Saad,&nbsp;N.K. Gaballa,&nbsp;H.R. Alkashgari,&nbsp;A. Abodonya,&nbsp;A.G.S. Elsawy,&nbsp;A.M.A. Khalifa,&nbsp;S. Abdalla Moursi,&nbsp;M. Mostafa Elshamy,&nbsp;M. Hegab,&nbsp;E.F. Ismail,&nbsp;A. Deyab,&nbsp;R. Elsafty,&nbsp;I. Eltanani","doi":"10.1016/j.redar.2026.502196","DOIUrl":"10.1016/j.redar.2026.502196","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the oropharyngeal leak pressure and clinical performance of the Baska Mask® and the ProSeal™ laryngeal mask airway (LMA) during controlled ventilation in gynecologic laparoscopic surgery.</div></div><div><h3>Methods</h3><div>This prospective randomized controlled trial included 100 adult women with American Society of Anesthesiologists (ASA) physical status I–II undergoing elective gynaecologic laparoscopic surgery. After induction of general anesthesia, patients were randomized to insertion of either the Baska Mask® (BM group, n<!--> <!-->=<!--> <!-->50) or the ProSeal laryngeal mask airway (PL group, n<!--> <!-->=<!--> <!-->50). The primary outcome was oropharyngeal leak pressure measured 10<!--> <!-->minutes after establishment of pneumoperitoneum. Secondary outcomes included insertion time, ease of insertion, number of insertion attempts, intraoperative device displacement, and perioperative airway-related complications.</div></div><div><h3>Results</h3><div>Oropharyngeal leak pressure was significantly higher in the BM group than in the PL group (median [IQR], 31 [28–33] vs 26 [25–28]<!--> <!-->cmH₂O; p<!--> <!-->&lt;<!--> <!-->0.001). Insertion time was significantly shorter with the Baska Mask® (9 [7–10]<!--> <!-->s vs 15 [13–16.8]<!--> <!-->s; p<!--> <!-->&lt;<!--> <!-->0.001). First-attempt success rates were comparable (96% vs 90%). Device displacement, blood-tinged sputum, and postoperative pharyngolaryngeal discomfort were not significantly different between groups. No patient required endotracheal intubation, and no episodes of vomiting occurred.</div></div><div><h3>Conclusion</h3><div>In gynaecologic laparoscopic surgery, the Baska Mask® provided higher oropharyngeal leak pressure and faster insertion than the ProSeal LMA, with a comparable perioperative safety profile.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 8","pages":"Article 502196"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valor pronóstico de la amplitud de distribución eritrocitaria y el lactato para la mortalidad a corto y largo plazo en pacientes críticos con lesión renal aguda","authors":"A. Guevara-Tirado","doi":"10.1016/j.redar.2026.502175","DOIUrl":"10.1016/j.redar.2026.502175","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute kidney injury in intensive care units is associated with high mortality, highlighting the need for simple biomarkers to improve prognostic stratification.</div></div><div><h3>Objective</h3><div>To evaluate the prognostic value of RDW and lactate for short- and long-term mortality in critically ill patients with acute kidney injury.</div></div><div><h3>Materials and methods</h3><div>An analytical study using an open dataset including 2,139 patients with acute kidney injury during their first ICU admission. The main biomarkers were RDW and lactate measured within the first 24<!--> <!-->hours, classified into four combined categories. Outcomes were 28-day, 90-day, and 1-year mortality. Multivariable logistic regression, Kaplan–Meier survival curves, and adjusted Cox proportional hazards models were used. Results were reported as odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals.</div></div><div><h3>Results</h3><div>Mortality increased across the combined RDW–lactate categories, with the highest rates observed in patients with both biomarkers elevated: 32.1% at 28 days, 43.6% at 90 days, and 53.0% at 1 year. In adjusted models, both RDW and lactate were independently associated with higher mortality. The RDW × lactate interaction was significant for 90-day mortality (OR 1.13). Cox analysis confirmed a higher risk of 90-day mortality in patients with both biomarkers elevated (HR 1.57). Kaplan–Meier curves showed significant differences in survival (<em>log-rank</em> p&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>The combined evaluation of RDW and lactate may improve short- and long-term mortality risk stratification in critically ill patients with acute kidney injury.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 8","pages":"Article 502175"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La contribución histórica e innovadora de España al manejo de la vía aérea","authors":"M.Á. Gómez-Ríos,&nbsp;A. Abad-Gurumeta,&nbsp;A.A.J. van Zundert","doi":"10.1016/j.redar.2026.502049","DOIUrl":"10.1016/j.redar.2026.502049","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 8","pages":"Article 502049"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149071964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encefalopatía aguda asociada a anestesia general en un paciente adulto portador de la variante m.11232T>C en el gen MT-ND4","authors":"I. Arranz Chamorro,&nbsp;P. Blanco-Schweizer,&nbsp;E. Ruiz Pesini,&nbsp;M. Busto Busto,&nbsp;T. Ticona Espinoza,&nbsp;J. Rodríguez Jiménez","doi":"10.1016/j.redar.2026.502103","DOIUrl":"10.1016/j.redar.2026.502103","url":null,"abstract":"<div><div>We report the case of a 20-year-old woman who developed acute encephalopathy after uneventful general anesthesia with sevoflurane, propofol, and opioids. The patient presented neurological impairment followed by metabolic acidosis and hyperlactatemia and neuroimaging findings involving the basal ganglia, brainstem, and cerebellum. Genetic testing confirmed the mitochondrial variant m.11232T&gt;C in the <em>MT-ND4</em> gene, previously described only in pediatric patients. This case could be one of the first cases described in the literature of acute encephalopathy associated with this mutation in an adult patient, possibly precipitated by exposure to volatile anesthetics. The patient's favorable clinical and radiological evolution after intensive neuroprotective management and suboccipital decompressive craniectomy highlights the importance of early diagnosis and individualized treatment. Mitochondrial dysfunction should be considered in atypical neurological presentations following general anesthesia, especially when accompanied by lactic acidosis and unusual neuroimaging findings.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 8","pages":"Article 502103"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149071963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eventos adversos graves asociados a anestesia general con agentes halogenados en pacientes de ascendencia venezolana. Recomendaciones en práctica clínica","authors":"E. Méndez Martínez,&nbsp;C. García Cebrián,&nbsp;A.M. González González,&nbsp;P. Sanabria Carretero,&nbsp;F. Munar Bauzá,&nbsp;G. Alcaraz García-Tejedor,&nbsp;P. González Pizarro,&nbsp;D. Méndez Marín,&nbsp;F. Cassinello,&nbsp;J. Encarnación Martínez,&nbsp;K. Sifontes Romero,&nbsp;M. Almena Marjalizo,&nbsp;C.L. Errando Oyonarte,&nbsp;F.J. Escribà Alepuz,&nbsp;J. García Fernández","doi":"10.1016/j.redar.2026.502167","DOIUrl":"10.1016/j.redar.2026.502167","url":null,"abstract":"<div><div>The mtND4 Working Group of the Spanish Society of Anesthesiology and Resuscitation (SEDAR) has issued clinical practice recommendations. This article stems from reports of neurological injury and death following general anesthesia in adult and pediatric patients of maternal Venezuelan ancestry, in whom a possible mitochondrial susceptibility associated with the mtND4 m.11232T&gt;C variant of respiratory chain complex I has been identified.</div><div>This document is for informational and guidance purposes only. The final clinical decision should be individualized for each patient, taking into account the urgency of the procedure, therapeutic alternatives, and the resources available at each center.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 8","pages":"Article 502167"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anestesia fuera del quirófano: una asignatura pendiente en nuestros hospitales","authors":"P.A. Vullo,&nbsp;J.J. Ariño Irujo","doi":"10.1016/j.redar.2026.502105","DOIUrl":"10.1016/j.redar.2026.502105","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 8","pages":"Article 502105"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149071965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asociación entre la concentración de lactato preoperatorio y la mortalidad intrahospitalaria tras la cirugía de urgencia","authors":"J. Ripollés-Melchor,&nbsp;P. Galán-Menéndez,&nbsp;Á.V. Espinosa,&nbsp;D. Fernández-García,&nbsp;A. Abad-Motos,&nbsp;R. Navarro-Pérez,&nbsp;R. Budithi,&nbsp;P. Fernández-Valdes-Bango,&nbsp;A. Abad-Gurumeta,&nbsp;C. Aldecoa","doi":"10.1016/j.redar.2026.502208","DOIUrl":"10.1016/j.redar.2026.502208","url":null,"abstract":"<div><h3>Introduction</h3><div>Lactate is widely used as a marker of metabolic and circulatory stress, but its prognostic value in emergency surgical populations remains incompletely defined.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the INSPIRE dataset, including emergency surgical procedures with a preoperative lactate measurement within six hours before incision. The primary outcome was in-hospital mortality. Multivariable logistic regression adjusted for age, sex, ASA physical status, surgical department, anaesthesia type, preoperative haemoglobin and creatinine. Lactate was analysed using restricted cubic splines and in prespecified categories (&lt;2, 2–&lt;<!--> <!-->4 and ≥4 mmol l^-1). Incremental prognostic value was assessed by comparing a baseline clinical model with and without lactate.</div></div><div><h3>Results</h3><div>The analytic cohort included 3729 emergency surgical procedures, of which 360 resulted in in-hospital death (9.7%). Mortality increased across lactate categories: 6.9% for lactate &lt;<!--> <!-->2 mmol l^-1, 13.9% for lactate 2–&lt;<!--> <!-->4 mmol l^-1 and 42.2% for lactate ≥4 mmol l^-1. After adjustment, lactate remained associated with mortality (odds ratio 1.79 [95% CI 1.23–2.59] for 2–&lt;<!--> <!-->4 mmol l^–1 and 7.34 [4.65–11.57] for ≥4 mmol l^-1 vs. &lt;<!--> <!-->2 mmol l^-1). Adding lactate to the standard clinical model improved discrimination (AUC 0.755 vs. 0.801) and reduced the Brier score (0.094 vs. 0.088). Results were consistent across alternative measurement windows and after multiple imputation.</div></div><div><h3>Conclusion</h3><div>Preoperative lactate concentration was strongly associated with in-hospital mortality and provided incremental prognostic information beyond routinely available variables. In emergency surgical pathways, lactate may support early risk stratification.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 8","pages":"Article 502208"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}