Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Delirium postoperatorio: de la evidencia internacional a la práctica en España. Una asignatura pendiente","authors":"E.M. Aldana , C. Aldecoa","doi":"10.1016/j.redar.2025.501920","DOIUrl":"10.1016/j.redar.2025.501920","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501920"},"PeriodicalIF":0.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722116","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":"Índices Doppler de la arteria cubital, un nuevo predictor emergente de la preservación segmentaria del cúbito después del bloqueo supraclavicular: un estudio observacional prospectivo","authors":"M. Adolf Helmy,&nbsp;M. Medhat Megalaa,&nbsp;H. Mohamed Mamdouh,&nbsp;I.A. Ismail,&nbsp;L. Magdy Milad","doi":"10.1016/j.redar.2025.501899","DOIUrl":"10.1016/j.redar.2025.501899","url":null,"abstract":"<div><h3>Background</h3><div>Supraclavicular brachial plexus block offers several advantages over general anesthesia, yet segmental ulnar sparing is one of the procedure's key drawbacks. Many parameters were proposed to ascertain segmental ulnar sparing, including thermal imaging and perfusion index. However, none proved optimal; therefore, we aimed to evaluate ulnar artery Doppler indices as a potential predictor of segmental ulnar sparing.</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted at a tertiary center. To obtain a study power of 90% and an alpha error of 0.05, a minimum sample size of 62 patients was required, with a minimum of 11 patients exhibiting segmental ulnar sparing. Adult patients who received supraclavicular brachial plexus block for hand surgery were included. Each dermatome was assessed in terms of motor and sensory function. An experienced operator performed Doppler examinations at baseline, 10-, 20-, and 30<!--> <!-->minutes following block administration. The primary outcome was the accuracy of the change in PI (ΔPI) in predicting segmental ulnar sparing. Other outcomes included the change in resistive index (ΔRI) and the change in waveform morphology (ΔM) to predict segmental ulnar sparing</div></div><div><h3>Results</h3><div>Of the 81 patients assessed for eligibility, 15 were excluded, leaving sixty-six in the final analysis. Eleven of the 66 individuals showed segmental ulnar sparing. ΔPI and ΔRI have been identified as accurate predictors of segmental ulnar sparing with best cut-off values of &lt;<!--> <!-->8.8% and 12%, respectively. Additionally, ulnar artery Doppler morphological changes from triphasic pattern to a monophasic wave can rule out segmental ulnar sparing with a 100% negative predictive value.</div></div><div><h3>Conclusion</h3><div>In adult patients undergoing hand surgery using supraclavicular brachial plexus block, Changes of Doppler indices, namely ΔPI, ΔRI, and ΔM, showed good accuracy in predicting segmental ulna preservation. However, the generalizability of our findings is limited by being a single-center study with a relatively small sample size.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501899"},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134821","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":"Reglas de predicción clínica en los pacientes con dolor neuropático periférico de etiología traumática tratados con parche de capsaicina al 8%","authors":"L. Monteagudo Moreno ,&nbsp;P. Cía Blasco ,&nbsp;M. Malo Urriés ,&nbsp;A. Nuez Polo ,&nbsp;C. Marín Zaldívar","doi":"10.1016/j.redar.2025.501880","DOIUrl":"10.1016/j.redar.2025.501880","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Neuropathic pain (NP) is a widespread, complex disorder that responds differently to pharmacological treatment. The aim of this study was to identify the baseline characteristics of good response to capsaicin 8% patch in patients with trauma-induced peripheral neuropathic pain (PNP).</div></div><div><h3>Materials and methods</h3><div>We performed a prospective, longitudinal, open-label study in 31 patients with PNP treated with 1-3 applications of the capsaicin 8% patch for 52 weeks. Response to treatment was defined as a reduction in the Visual Analogue Scale (VAS) score compared to baseline. Data from responders and non-responders were compared at the start (month 1) and end (month 12) of treatment. Logistic regression was used to identify predictors of treatment response.</div></div><div><h3>Results</h3><div>At month 1, responders (n<!--> <!-->=<!--> <!-->17) had significantly larger treatment areas (155.18 cm² vs. 59.21 cm²; <em>P</em>=.004) and reported greater pain relief with treatments received in the previous week in the brief pain questionnaire (34.7% vs. 14.3%; <em>P</em>=.023). At month 12, significant predictors included cold allodynia (OR 8; <em>P</em>=.030), positive for painful cold in the DN4 questionnaire (OR 7.936; <em>P</em>=.019), no penetrating pain (OR 16.800; <em>P</em>=.009), and pain interference with work score &lt;<!--> <!-->7.5 (OR 7.917; <em>P</em>=.019).</div></div><div><h3>Conclusions</h3><div>This study makes a significant contribution to the management of post-traumatic peripheral neuropathic pain by providing tools to personalize treatment and optimize available resources.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501880"},"PeriodicalIF":0.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721975","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":"Manejo perioperatorio de los pacientes en tratamiento con agonistas del receptor GLP-1: riesgos y recomendaciones","authors":"E. Simón Polo,&nbsp;I. Rubio Jiménez,&nbsp;N. Aguirre Ahedo,&nbsp;M. Sanjuán Fernández","doi":"10.1016/j.redar.2025.501859","DOIUrl":"10.1016/j.redar.2025.501859","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501859"},"PeriodicalIF":0.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134788","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":"Explorar el rol de la citometría de flujo para la evaluación de las células endoteliales en la sepsis humana: una revisión sistemática","authors":"M. Bardají-Carrillo ,&nbsp;M. Martín-Fernández ,&nbsp;A. García-Concejo ,&nbsp;Á. Tamayo-Velasco ,&nbsp;D. Bernardo ,&nbsp;E. Tamayo","doi":"10.1016/j.redar.2025.501850","DOIUrl":"10.1016/j.redar.2025.501850","url":null,"abstract":"<div><h3>Introduction</h3><div>Given the key role of the endothelium in organ failure secondary to sepsis, we reviewed the available literature on the use of flow cytometry (FC) to analyse endothelial cells in human sepsis.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed and Web of Science from inception until November 2024 to identify original research articles describing the use of FC to study human endothelial cells in sepsis.</div></div><div><h3>Results</h3><div>A total of 395 original articles were found; 36 met the inclusion criteria. Ten studied circulating mature (CEC) or progenitor (CEPC) endothelial cells. High CEC and/or CEPC counts correlated with higher mortality; CEC numbers were increased even before the onset of shock. Twenty-six manuscripts studied the phenotype of different human microvascular endothelial cells (HMEC), and showed that expression of adhesion molecules ICAM-1, VCAM-1 and E-selectin were increased in sepsis, but there was no evidence of their association with severity or mortality.</div></div><div><h3>Conclusion</h3><div>High CEC and CEPC counts correlate with sepsis severity and mortality, confirming that their assessment by FC can shed some light on early sepsis diagnosis.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501850"},"PeriodicalIF":0.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722123","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":"Delirio postoperatorio en adultos mayores: un estudio de cohorte retrospectivo","authors":"J.A. Vélez-Restrepo ,&nbsp;P.A. Betancourt-Ángel ,&nbsp;J.D. Caicedo-Jaramillo ,&nbsp;F.D. Casas-Arroyave","doi":"10.1016/j.redar.2025.501855","DOIUrl":"10.1016/j.redar.2025.501855","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Postoperative delirium (POD) is an adverse outcome that has garnered significant interest in perioperative medicine, particularly in older adults, due to its association with increased morbidity, mortality, and health care costs. In Colombia, this disease is under-reported due to the lack of POD diagnosis and prevention protocols. The aim of this study was to determine the incidence and potential risk factors of POD, and its association with other postoperative complications.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study was performed at a tertiary care hospital. Patients over 60<!--> <!-->years of age who underwent surgery between 2012 and 2019 were included. Random sampling was used to analyse electronic medical records to estimate the incidence of POD, risk factors, and postoperative complications within 7<!--> <!-->days of surgery.</div></div><div><h3>Results</h3><div>A total of 2535 patients were evaluated. The cumulative incidence of POD was 6.0% (95% confidence interval [CI]: 5.1%-6.9%), with most cases (67%) occurring within the first 3<!--> <!-->postoperative days. Risk factors associated with POD included a history of psychiatric disorders, preoperative opioid use, ASA (American Society of Anesthesiologists) class<!--> <!-->III/IV, vascular surgery, urgent or emergency surgery, and functional dependency. POD was also associated with higher in-hospital mortality (OR: 2.9; 95%<!--> <!-->CI: 1.66-5.07).</div></div><div><h3>Conclusion</h3><div>POD is common in patients aged over 60 undergoing surgery, particularly those that undergo urgent or emergency procedures and vascular surgery, who are ASA class &gt;<!--> <!-->III, functionally dependent, and present psychiatric disorders. POD is also associated with increased postoperative morbidity and mortality.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501855"},"PeriodicalIF":0.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722122","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":"Viabilidad y aceptabilidad de una app para el seguimiento del dolor agudo postoperatorio en cirugía mayor ambulatoria","authors":"S. Vitale,&nbsp;M.I. Fábregas Blanco,&nbsp;P. Ricós Bugeda,&nbsp;R. Torruella Turró,&nbsp;H. Fernández Fernández,&nbsp;E. Reñé de Antonio","doi":"10.1016/j.redar.2025.501854","DOIUrl":"10.1016/j.redar.2025.501854","url":null,"abstract":"<div><h3>Introduction</h3><div>By allowing intensive monitoring of acute postoperative pain (APP), mHealth could be clinically useful in contexts with a high prevalence of moderate to severe APP.</div></div><div><h3>Objectives</h3><div>The primary objective was to evaluate the feasibility and acceptability of an app for monitoring APP. The secondary objectives were to describe APP during the first week of the postoperative period, to analyse factors associated with it and to assess adherence and satisfaction with analgesic treatment.</div></div><div><h3>Materials and methods</h3><div>Observational and prospective study in patients undergoing surgery under major ambulatory surgery regimen who reported the intensity of APP for 7 days with an app. We determined the proportions that agreed to use it and who made trajectories of APP<!--> <!-->≥<!--> <!-->5 days, the pattern of use of the app and the results. Risk factors associated with APP were analyzed. Satisfaction with APP control and adherence to the analgesic regimen were assessed through surveys.</div></div><div><h3>Results</h3><div>A percentage of 53.4 of patients measured their APP with the app. The main reason for exclusion was technological limitations (75.1%). An uninterrupted APP trajectory of<!--> <!-->≥<!--> <!-->5 days was traced in 74.4% of patients and a high prevalence of moderate to severe APP was observed, as well as a high proportion of patients who adhered little or not at all and were little or not at all satisfied with the analgesic results obtained.</div></div><div><h3>Conclusions</h3><div>Monitoring APP with the app used was feasible and accepted by patients. It provided clinically useful information by allowing APP trajectories to be traced and detecting high proportions of patients with moderate to severe APP, dissatisfied with the analgesic results obtained and non-compliant with analgesic guidelines.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501854"},"PeriodicalIF":0.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134783","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":"Estimación del volumen mínimo efectivo 90% (VME90) de Ropivacaína® al 0,5% en bloqueo interescalénico ecoguiado para analgesia postoperatoria en cirugía artroscópica de hombro: un estudio prospectivo observacional de determinación de dosis y evaluación de la función diafragmática","authors":"B. Moreno ,&nbsp;V. Domingo ,&nbsp;M. Granell ,&nbsp;J.M. Palanca ,&nbsp;S. Selfa","doi":"10.1016/j.redar.2025.501731","DOIUrl":"10.1016/j.redar.2025.501731","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Ultrasound-guided ISB is the most widely-used nerve block in upper limb surgery. The aim of this study was to determine the MEV90 of 0.5% ropivacaine in ISB for analgesia in arthroscopic shoulder surgery.</div></div><div><h3>Methodology</h3><div>Double-blind observational post-authorization study of a medicinal product for human use. Thirty-two ASA I-III patients aged between 18 and 75 years undergoing arthroscopic shoulder surgery were recruited. We used the Dixon up-down method, whereby the dose is increased or decreased by 1<!--> <!-->ml depending on the failure or success of the block. The initial dose was 20<!--> <!-->ml of 0.5% ropivacaine. The study was stopped after achieving the minimum 5 negative-positive deflections. Secondary variables were the duration of the block, total analgesia consumption over the first 24<!--> <!-->hours, and incidence of DP.</div></div><div><h3>Results</h3><div>The effective LA dose for postoperative analgesia in arthroscopic shoulder surgery was 6.8<!--> <!-->ml in 50% of patients (MEV50) (90% CI: 6.234.7.465) and 7.733<!--> <!-->ml in 90% of patients (MEV90) (90% CI: 7.393-9.109). Median sensory block duration was 772.5<!--> <!-->minutes. The incidence of partial and total DP in QB was 34% and 41%, respectively.</div></div><div><h3>Conclusion</h3><div>A dose of 7.733<!--> <!-->ml of 0.5% ropivacaine provides effective postoperative analgesia in arthroscopic shoulder surgery in 90% of patients. This lower dose reduces the likelihood of side effects.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 6","pages":"Article 501731"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212193","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":"¿Debería actualizarse la definición de dolor neuropático?","authors":"A. Alcántara Montero","doi":"10.1016/j.redar.2025.501751","DOIUrl":"10.1016/j.redar.2025.501751","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 6","pages":"Article 501751"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212260","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":"Aplicación de chatbots de inteligencia artificial generativa en el campo de la anestesia","authors":"A. Barroso ,&nbsp;R. Casans","doi":"10.1016/j.redar.2024.501667","DOIUrl":"10.1016/j.redar.2024.501667","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 6","pages":"Article 501667"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212194","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}