Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Efecto Macklin en pacientes de COVID-19 críticos: análisis unicéntrico observacional","authors":"G. Melegari ,&nbsp;F. Arturi ,&nbsp;G. Vaccari ,&nbsp;F. Gazzotti ,&nbsp;E. Bertellini ,&nbsp;L. Astore ,&nbsp;G. Della Casa ,&nbsp;A. Pecchi ,&nbsp;A. Barbieri","doi":"10.1016/j.redar.2025.501930","DOIUrl":"10.1016/j.redar.2025.501930","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the incidence and impact of the Macklin effect (ME) in critically ill COVID-19 patients and its correlation with pneumothorax (PNX), spontaneous pneumomediastinum (SP), and barotraumatic complications (BC).</div></div><div><h3>Design</h3><div>Observational single-center study.</div></div><div><h3>Setting</h3><div>Intensive Care Unit (ICU) of a single Italian hospital.</div></div><div><h3>Patients or participants</h3><div>Critically ill COVID-19 patients aged ≥18 years, with at least one chest computed tomography (Ch-CT) scan and undergoing mechanical ventilation. Patients with pre-existing PNX, SP, or tracheal lesions at ICU admission were excluded.</div></div><div><h3>Interventions</h3><div>Retrospective analysis of Ch-CT scans to detect ME.</div></div><div><h3>Main variables of interest</h3><div>ME incidence, its correlation with barotrauma development and mortality.</div></div><div><h3>Results</h3><div>Among 138 patients, ME was detected in 5.80% (8 cases) on the first Ch-CT scan and in 10.87% (15 cases) at any time during ICU stay. PNX occurred in 17.39% (24 cases) and subcutaneous emphysema in 14.49% (20 cases), with a total BC incidence of 23.91% (33 cases). ME presence on the first Ch-CT scan was significantly associated with PNX (OR 5.5, p<!--> <!-->=<!--> <!-->0.012), SP (OR 12.77, p<!--> <!-->&lt;<!--> <!-->0.001), and BC (OR 11.44, p<!--> <!-->=<!--> <!-->0.004). ME detection on the first Ch-CT scan showed a Hazard Ratio (HR) of 5.91 (CI 2.41-14.50, p<!--> <!-->&lt;<!--> <!-->0.001) for BC development.</div></div><div><h3>Conclusions</h3><div>Early ME detection in critically ill COVID-19 patients is crucial, as it is significantly associated with PNX, SP, and BC. Recognizing ME could play a role in improving clinical management and outcomes.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501930"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617562","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":"Evaluación preoperatoria de la función cognitiva: idoneidad y resultados","authors":"B. Tena,&nbsp;A. Fervienza,&nbsp;I. Gracia,&nbsp;N. Fábregas","doi":"10.1016/j.redar.2025.501857","DOIUrl":"10.1016/j.redar.2025.501857","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501857"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617564","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 anestésico de la reparación endovascular del arco aórtico con la prótesis NEXUS TRE™: a propósito de un caso clínico","authors":"J.A. Rodenas-Rubio ,&nbsp;J. Guillén-Perales ,&nbsp;M. Vintimilla-Izquierdo","doi":"10.1016/j.redar.2025.501914","DOIUrl":"10.1016/j.redar.2025.501914","url":null,"abstract":"<div><div>Endovascular aortic arch surgery is an evolving field that offers less invasive alternatives to open surgery. The emergence of new devices and their implantation imply new considerations in the management by the anaesthesiologist during the procedure. An example of this is the NEXUS TRE™ stent, designed to preserve the patency of the supra-aortic trunks without the need for extra-anatomic bypass. We present the case of a 75-year-old man diagnosed with an aortic arch aneurysm with accelerated growth and risk of rupture, who underwent endovascular repair of the aortic arch and its 3 branches with the NEXUS TRE™ stent. This is one of the first cases carried out in Europe, specifically in Spain.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501914"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617467","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":"Dolor neuropático y crónico de nueva aparición en supervivientes de COVID-19 grave: análisis secundario del ensayo PAIN-COVID","authors":"A. Ojeda,&nbsp;T. Cuñat,&nbsp;O. Comino-Trinidad,&nbsp;J. Aliaga,&nbsp;M. Arias,&nbsp;A. Calvo","doi":"10.1016/j.redar.2025.501915","DOIUrl":"10.1016/j.redar.2025.501915","url":null,"abstract":"<div><h3>Background</h3><div>Survivors of critical illnesses, including COVID-19, are at risk of developing Chronic ICU-Related Pain (CIRP) and neuropathic pain (NP). This study evaluates the incidence of CIRP and NP 6 months after hospital discharge and their impact on pain intensity, functional status, and quality of life (QoL).</div></div><div><h3>Methods</h3><div>We performed an observational prospective cohort analysis based on a secondary analysis of data from the existing PAIN-COVID randomized controlled trial, which included adult survivors of severe COVID-19 admitted to the ICU. CIRP and NP were assessed at 6 months post-discharge using validated scales (Brief Pain Inventory [BPI] and DN4-interview). Propensity score matching was used to control for confounding factors when comparing pain intensity, functional impact, and QoL between groups.</div></div><div><h3>Results</h3><div>New-onset CIRP was reported by 47.7% of patients. In matched cohorts, patients with CIRP had significantly lower EQ-5D-5L index (0.705 [0.613-0.818]; <em>p</em>&lt;<!--> <!-->0.001) and VAS (72 [60–80]; <em>p</em> <!-->=<!--> <!-->0.019) scores compared to those without pain. NP affected 36.5% of patients. Patients with NP showed higher BPI-intensity (5.3 [2.5–6], p<!--> <!-->=<!--> <!-->0.002) and BPI-interference scores (4.5 [1.5–6.9], p<!--> <!-->=<!--> <!-->0.025). The EQ-5D-5L index (0.68 [0.36-0.81]; <em>p</em> <!-->=<!--> <!-->0.29) and VAS scores (60 [47.5–85]; <em>p</em> <!-->=<!--> <!-->0.032) were lower compared to those without NP.</div></div><div><h3>Conclusion</h3><div>A substantial proportion of COVID-19 ICU survivors develop new-onset CIRP and NP within 6 months after discharge, resulting in significant impairment in QoL.</div></div><div><h3>Trial registration</h3><div># NCT04394169, registered on 5/19/2020.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501915"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617560","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":"Calidad de la formación en anestesia regional ecoguiada en hospitales docentes de Cataluña: una encuesta de opinión de residentes y tutores","authors":"C. Barreiros ,&nbsp;J. Mejía ,&nbsp;I. García-Rojas ,&nbsp;X. Sala-Blanch","doi":"10.1016/j.redar.2025.501913","DOIUrl":"10.1016/j.redar.2025.501913","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501913"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398367","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":"Bloqueo ecoguiado del canal del aductor: ¿puede el abordaje del eje corto oblicuo facilitar la inserción del catéter perineural? Estudio controlado aleatorizado","authors":"M.A.R. Nasr,&nbsp;A. Ahmed,&nbsp;N. Ahmed,&nbsp;S. Soaida,&nbsp;M. Waheeb","doi":"10.1016/j.redar.2025.501901","DOIUrl":"10.1016/j.redar.2025.501901","url":null,"abstract":"<div><h3>Introduction</h3><div>The transverse short-axis in-plane is the standard approach for ultrasound-guided perineural catheter insertion and threading during adductor canal block (BCA). We hypothesized that the oblique short-axis in-plane approach could simplify and speed up catheter insertion and threading by eliminating some technical difficulties.</div></div><div><h3>Methods</h3><div>We included 50 patients aged ≥<!--> <!-->18<!--> <!-->years, ASA<!--> <!-->I and<!--> <!-->II, who were scheduled for unilateral knee arthroscopy under spinal anesthesia. We planned to use BCA with a perineural catheter for postoperative analgesia. After administering spinal anesthesia, the patients were randomly assigned to the oblique (oblique short-axis in-plane approach) or transverse (standard short-axis in-plane approach) groups. The primary endpoint was catheter insertion time. The secondary endpoints were catheter threading difficulty, and incidence of vascular puncture and catheter migration.</div></div><div><h3>Results</h3><div>The catheter insertion time was significantly shorter in the oblique group vs the transverse group (113.8<!--> <!-->±<!--> <!-->49.2<!--> <!-->s vs 185.8<!--> <!-->±<!--> <!-->46.7<!--> <!-->s, respectively, <em>P</em> <!-->&lt;<!--> <!-->.001). Catheter threading was significantly easier in the oblique group, as shown by the lower threading difficulty score compared to the transverse group. Both groups were comparable in terms of the incidence of vascular puncture and catheter migration.</div></div><div><h3>Conclusion</h3><div>In patients who underwent knee arthroscopy under spinal anesthesia, the oblique short-axis in-plane approach for catheter insertion during BCA was faster and less technically challenging than the standard transverse short-axis in-plane approach.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501901"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398373","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":"Nueve pasos clave en anestesia regional: infografía para su adopción clínica","authors":"P. Galli ,&nbsp;H. Labandeyra ,&nbsp;G. Irizaga ,&nbsp;A. Schwartzmann","doi":"10.1016/j.redar.2025.501900","DOIUrl":"10.1016/j.redar.2025.501900","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501900"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398368","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":"Programas de mejora de la calidad perioperatoria: se necesita urgentemente una red perioperatoria para promover la educación, la colaboración y la innovación contextual","authors":"H.D. de Boer,&nbsp;B.M. Biccard,&nbsp;B.R. Martini","doi":"10.1016/j.redar.2025.501928","DOIUrl":"10.1016/j.redar.2025.501928","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501928"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398370","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":"Recuperación mejorada tras la cirugía y resultados oncológicos a largo plazo: análisis post hoc del estudio POWER","authors":"J. Ripollés-Melchor ,&nbsp;A. Zorrilla-Vaca ,&nbsp;A. León-Bretscher ,&nbsp;A. Abad-Motos ,&nbsp;P. Galán-Menéndez ,&nbsp;J.L. Muñoz-Rodés ,&nbsp;D. Zapata ,&nbsp;Á. Ramiro-Ruiz ,&nbsp;C. Aldecoa ,&nbsp;V. Molnar ,&nbsp;L. Jordá-Sanz ,&nbsp;A. Cuéllar-Martínez ,&nbsp;H. Berges-Gutiérrez ,&nbsp;A. Landaluce-Olavarria ,&nbsp;R. Fernández-García ,&nbsp;N. Aracil-Escoda ,&nbsp;A.M. Pacual-Bellosta ,&nbsp;M. Ubré-Lorenzo ,&nbsp;M. Logroño-Ejea ,&nbsp;A.B. Serrano Romero ,&nbsp;A. Abad-Gurumeta","doi":"10.1016/j.redar.2025.501926","DOIUrl":"10.1016/j.redar.2025.501926","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Colorectal cancer (CRC) remains a leading cause of cancer-related mortality. While Enhanced Recovery After Surgery (ERAS) programs optimize perioperative care, their effect on oncologic prognosis requires further validation. This study evaluates ERAS adherence and five-year survival through a post-hoc analysis of the POWER Study.</div></div><div><h3>Methods</h3><div>This sub-analysis included 901 patients from 32 hospitals with available five-year follow-up data. Patients undergoing elective CRC resection were stratified based on ERAS adherence (≥<!--> <!-->70%). Primary outcomes included overall survival and recurrence rates, analyzed using Cox proportional hazards models adjusted for clinical variables. Kaplan-Meier curves and subgroup analyses were also performed to assess stage-specific differences.</div></div><div><h3>Results</h3><div>No significant differences were observed in five-year overall survival (ERAS 66% vs. non-ERAS 60%; HR: 1.14, 95% CI: 0.88-1.49; P<!--> <!-->=<!--> <!-->0.32) or recurrence rates (ERAS 25% vs. non-ERAS 25%; HR: 0.91, 95% CI: 0.68-1.22; P<!--> <!-->=<!--> <!-->0.53). Kaplan-Meier curves showed overlapping survival trajectories, and subgroup analyses confirmed no stage-specific disparities. While ERAS promotes early postoperative recovery and facilitates timely adjuvant therapy initiation, its effect on long-term oncologic outcomes remains inconclusive.</div></div><div><h3>Conclusions</h3><div>These findings support ERAS as a safe perioperative strategy that enhances short-term recovery without compromising oncologic safety. However, limitations such as the post-hoc design and incomplete long-term data warrant further research. Future studies should investigate ERAS's impact on perioperative stress, immune function, and recurrence prevention to better elucidate its role in long-term CRC outcomes.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501926"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398371","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":"Toxina botulínica perineural en el tratamiento de la cefalea postraumática. Caso clínico","authors":"L. Arce Gálvez ,&nbsp;J.M. Mancera Álzate","doi":"10.1016/j.redar.2025.501903","DOIUrl":"10.1016/j.redar.2025.501903","url":null,"abstract":"<div><div>Post-traumatic headache is a common condition that can be managed with pharmacologic interventions or analgesic procedures; however, most evidence is derived from patients with mild trauma, leaving a large gap with regard to patients with moderate or severe trauma who present complex pain. Botulinum toxin plays an increasingly important role in pain management. This neurotoxin acts on different receptors, ranging from TRPV1 (transient receptor potential vanilloid type<!--> <!-->1) to CGRP (calcitonin gene-related peptide). This is the first case report of the use of perineural botulinum toxin in a patient with moderate post-traumatic headache who responded poorly to standard interventional measures.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501903"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398366","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}