Revista Espanola de Anestesiologia y Reanimacion最新文献

Búsqueda en la literatura para la toma de decisiones relativa a la gestión sanitaria sobre cómo incrementar la productividad realizando más casos quirúrgicos en el mismo tiempo asignado

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI: 10.1016/j.redar.2024.501656

F. Dexter , M.Á. Gómez-Ríos , R.H. Epstein

{"title":"Búsqueda en la literatura para la toma de decisiones relativa a la gestión sanitaria sobre cómo incrementar la productividad realizando más casos quirúrgicos en el mismo tiempo asignado","authors":"F. Dexter , M.Á. Gómez-Ríos , R.H. Epstein","doi":"10.1016/j.redar.2024.501656","DOIUrl":"10.1016/j.redar.2024.501656","url":null,"abstract":"<div><div>This report shows how the results of a literature search for studies on healthcare management decision-making can help anaesthesiologists improve operating room (OR) turnover. The Scopus database was searched to obtain relevant studies on increasing surgery turnover. References and citations were then examined. The search identified strategies to reduce OR downtime time, facilitate overlapping surgeries, and optimize OR scheduling. Key findings show that reducing anaesthesia-controlled times alone is insufficient to reliably add extra surgical cases within an 8-hour workday. Instead, significant productivity gains are achieved by managing OR turnover times, using induction rooms, and revising workflows to maximize efficiency. Studies show that overlapping surgeries and strategic use of adjacent spaces can significantly increase the number of surgical cases performed daily. Most surgical growth is driven by accommodating low caseload surgeons across multiple specialties. Facilitating OR time access for these surgeons through flexible scheduling and re-sequencing of cases is crucial. Additionally, anaesthesiologists should be engaged in daily OR scheduling and case sequencing, particularly within 2 days of surgery. The dual goals are to increase OR utilization and reduce patient wait times. These results from the management case report underscores the importance of evidence-based OR management practices and proactive involvement of anaesthesiologists in scheduling decisions to enhance surgical turnover.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501656"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792829","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}

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¿Lecciones de historia para un futuro incierto? Anestesiología y reanimación durante el conflicto de Ifni-Sahara (1957-1958)

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI: 10.1016/j.redar.2024.07.002

R. Navarro-Suay , L.E. Togores-Sánchez , R. García-Cañas , F. Gilsanz-Rodríguez

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Elevación hemidiafragmática y colapso cardiovascular

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI: 10.1016/j.redar.2024.05.001

E. Soto Garrucho, F. Federero Martínez, F. Polonio Enríquez

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La vía aérea y el inconformismo hacia la excelencia

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI: 10.1016/j.redar.2025.501733

M.A. Gómez-Ríos , A.A.J. Van Zundert , M.A. Fernández-Vaquero

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Catéter intratecal tras punción dural en pacientes obstétricas: Seguridad y efectividad en la reducción de la cefalea post punción dural

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI: 10.1016/j.redar.2024.501671

G. Moreno Giménez, M.C. Melo Cruz, M. Ferrándiz Mach, S. Sabaté Tenas

{"title":"Catéter intratecal tras punción dural en pacientes obstétricas: Seguridad y efectividad en la reducción de la cefalea post punción dural","authors":"G. Moreno Giménez, M.C. Melo Cruz, M. Ferrándiz Mach, S. Sabaté Tenas","doi":"10.1016/j.redar.2024.501671","DOIUrl":"10.1016/j.redar.2024.501671","url":null,"abstract":"<div><h3>Background</h3><div>Post-dural puncture headache (PDPH) after an accidental dural puncture (ADP) is a common complication in obstetric analgesia. It has been proposed that inserting an intrathecal catheter (ITC) after an ADP may reduce PDPH incidence and the need for therapeutic epidural blood patch (EBP). Our primary objective was to assess if the insertion of an ITC after an ADP reduces the incidence of PDPH in obstetric patients. Secondary objectives included evaluating EBP requirements and ITC-related complications.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of all obstetric patients with a documented ADP during their labor analgesia between January 2018 to December 2022. Data from the patients in whom an ITC was inserted and those with a repeated epidural were compared.</div></div><div><h3>Results</h3><div>Over our 5-year study period, 35 cases of ADP were documented. Of these, 16 patients (45.7%) received an ITC for 24hours, while 19 (54.3%) underwent epidural re-siting. No significant difference was observed in PDPH incidence between ITC and re-sited epidural groups (62.5% vs 68.4%; RR: 0.84; <em>P</em>  =.387). Follow-up duration did not differ significantly between groups and no ITC-related complications were reported within 1month.</div></div><div><h3>Conclusions</h3><div>Our findings align with previously reported literature, indicating a trend favoring ITC utilization. In addition to the potential benefit of reducing PDPH incidence, their use is safe and provides quality analgesia with rapid onset.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501671"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792182","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}

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Utilidad de la ecografía de la vaina del nervio óptico durante la cirugía colorrectal laparoscópica

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI: 10.1016/j.redar.2024.501672

L. Alcover Navarro , C.S. Romero García , E. Mateo Rodríguez , P. Granero Castro , J. de Andrés Ibáñez

{"title":"Utilidad de la ecografía de la vaina del nervio óptico durante la cirugía colorrectal laparoscópica","authors":"L. Alcover Navarro , C.S. Romero García , E. Mateo Rodríguez , P. Granero Castro , J. de Andrés Ibáñez","doi":"10.1016/j.redar.2024.501672","DOIUrl":"10.1016/j.redar.2024.501672","url":null,"abstract":"<div><h3>Introduction</h3><div>Abdominal laparoscopic surgery to treat colorectal cancer has been shown to be more effective than open surgery in terms of mobility, hospital stay, tumour recurrence and long-term survival. This surgical approach requires pneumoperitoneum and the Trendelenburg position (35-45°), both of which have a negative effect on the cardiovascular system and can even change the cerebrovascular physiology, leading to an increase in intracranial pressure (ICP). Ultrasound measurement of optic nerve sheath (ONS) diameter has shown excellent correlation with invasive ICP measurement.</div></div><div><h3>Objective</h3><div>To correlate the increase in ONS diameter with surgical time and time to emergence after anaesthesia. The incidence of visual disturbances (visual acuity) and/or neurological complications (agitation, cognitive dysfunction) in the immediate postoperative period was also evaluated.</div></div><div><h3>Material and methods</h3><div>Thirty consecutive patients undergoing laparoscopic surgery for rectal or sigmoid adenocarcinoma were recruited. Pre-, intra- and postoperative ONS measurements were obtained and the Snellen test for visual acuity, Mini Mental Test for cognitive function, and the Richmond Agitation and Sedation Scale (RASS) were administered.</div></div><div><h3>Results</h3><div>The ONS increased intraoperatively in both eyes compared to baseline. However, this was not correlated with total surgical time or time to emergence, and there was no statistically significant correlation between ONS and postoperative neurological or visual alterations.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501672"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792183","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}

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Manejo anestésico de un paciente con dispositivo de modulación de la contractilidad cardiaca

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI: 10.1016/j.redar.2024.04.006

A. Álvarez Bartolomé , Á. Mingote Lladó , M. Casado Salcedo , J. García Fernández

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Complicaciones asociadas al retraso en la cirugía de fractura de cadera por antiagregantes plaquetarios

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI: 10.1016/j.redar.2024.501674

V. Moratalla Sasu, N. Bakhshaliyeva, J. Fernández González, E. Alday Muñoz

{"title":"Complicaciones asociadas al retraso en la cirugía de fractura de cadera por antiagregantes plaquetarios","authors":"V. Moratalla Sasu, N. Bakhshaliyeva, J. Fernández González, E. Alday Muñoz","doi":"10.1016/j.redar.2024.501674","DOIUrl":"10.1016/j.redar.2024.501674","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Hip fractures typically affect elderly individuals with multiple comorbidities. Early surgical intervention within the first 48hours has been shown to improve outcomes. However, when on antiplatelet therapy, surgery is often delayed preventing bleeding complications. This study aims to compare the incidence of perioperative complications, the need for blood transfusions, and the length of hospital stay between two groups of patients: those with delayed surgery more than 72hours due to antiplatelet use and those who had surgery within the first 48hours.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 110 patients who underwent hip fracture surgery between December 2012 and April 2018. Patients who had a delay of more than 72hours in the surgery were selected. A 1:1 randomized sampling was made to obtain a control group with surgery within the first 48hours.</div></div><div><h3>Results</h3><div>The baseline clinical characteristics were similar between the two groups, except for a higher rate of ischemic heart disease, cerebrovascular accidents and use of antiplatelet medication in the delayed surgery group. The early surgery group had a higher rate of acute renal failure (14.6% vs. 1.8%). The rest of the postoperative complications were higher in the delayed group (5.5% vs. 20%). The hospital stay was longer in the delayed group (15.2 vs. 8.93 days), although this difference accounted for the preoperative stay.</div></div><div><h3>Conclusion</h3><div>This study found that delayed surgery was linked to a higher incidence of medical complications and a longer hospital stay due to the wait time for surgery.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501674"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792828","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}

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Bloqueo del músculo erector de la espina para analgesia obstétrica en el déficit de Factor XI: a propósito de un caso

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI: 10.1016/j.redar.2024.03.010

P. Martín Serrano , A. Ferraz Pérez , C. Medina Hernández , V. Prieto Hidalgo

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Características clínicas e implicación pronóstica de la fibrilación auricular en el período postoperatorio de cirugía cardíaca con circulación extracorpórea

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI: 10.1016/j.redar.2024.501673

C.Y. Salinas-Ulloa , R. Gopar-Nieto , E. García-Cruz , G. Rojas-Velasco , D. Manzur-Sandoval

{"title":"Características clínicas e implicación pronóstica de la fibrilación auricular en el período postoperatorio de cirugía cardíaca con circulación extracorpórea","authors":"C.Y. Salinas-Ulloa , R. Gopar-Nieto , E. García-Cruz , G. Rojas-Velasco , D. Manzur-Sandoval","doi":"10.1016/j.redar.2024.501673","DOIUrl":"10.1016/j.redar.2024.501673","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the latest innovations in surgical and cardiopulmonary bypass techniques, atrial fibrillation remains a common arrhythmia in patients undergoing heart surgery, and has been shown to increase the incidence of intra- and postoperative complications. For this reason, it is among the top 10 research topics in cardiovascular surgery.</div></div><div><h3>Method</h3><div>Observational, analytical, retrospective study carried out at the largest cardiovascular centre in Mexico. Adult patients (>18 years) with no history of atrial fibrillation who underwent heart surgery with cardiopulmonary bypas between 1 January 2022 and 31 December 2023 were included. Variables that have previously been correlated with postoperative atrial fibrillation (POAF) were evaluated.</div></div><div><h3>Results</h3><div>A total of 544 patients were included. The incidence of POAF was 11.9%. Overall in-hospital mortality was 5.9%. There was a significant difference in age between patients that developed postoperative atrial fibrillation and those that maintained sinus rhythm (62 vs 57 years; p = ≤ 0.01). Using a univariate logistic regression model, we found that POAF significantly predicts the occurrence of hospital-acquired pneumonia (OR: 3.12; 95% CI: 1.61-6.02; <em>P</em>≤0.01) and the requirement for renal replacement therapy (OR: 3.04; 95% CI: 1.34-6.86; <em>P</em>≤0.01).</div></div><div><h3>Conclusions</h3><div>Atrial fibrillation is a common arrhythmia in the postoperative period of heart surgery with cardiopulmonary bypass, and is a predictor of adverse outcomes. Prevention, early detection and treatment of POAF may have prognostic implications.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501673"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792764","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}

引用次数: 0