Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Bloqueo del plano serrato intercostal frente al bloqueo del cuadrado lumbar posterior en nefrectomía laparoscópica: estudio aleatorizado, controlado, doble ciego","authors":"M.T. Fernandez Martin ,&nbsp;M.G. Matesanz ,&nbsp;J. Andres ,&nbsp;H. Muñoz ,&nbsp;M.F. Muñoz ,&nbsp;A. Fadrique ,&nbsp;P. Castillo ,&nbsp;P. Casas ,&nbsp;S. Lopez","doi":"10.1016/j.redar.2025.501728","DOIUrl":"10.1016/j.redar.2025.501728","url":null,"abstract":"<div><h3>Background</h3><div>Even though laparoscopic nephrectomy improves the quality of postoperative recovery, it still causes moderate to severe pain. Our objective was to determine whether serratus intercostal plane block (SIPB) was noninferior to posterior quadratus lumborum block (QLB) in terms of pain control and quality of recovery.</div></div><div><h3>Methods</h3><div>This multicentre, controlled, randomized, blinded study had a sample size of 120 patients who were randomly assigned to SIPB, QLB, and control groups prior to scheduled laparoscopic nephrectomy. We collected the following variables: postoperative dynamic pain scores at 0, 6, 12, and 24<!--> <!-->hours, postoperative quality of recovery (QoR15), and total opioid consumption (fentanyl and morphine).</div></div><div><h3>Results</h3><div>Our results show that SIPB was non-inferior to QLB with regard to the primary endpoint (NRS 0.4/0.9) and quality of recovery (QoR15 112.7/106.85) (<em>P</em> .27). Opioid consumption (fentanyl <em>P</em> .37 and morphine <em>P</em> .9) was similar in the SIPB and QLB groups, and both groups were superior to controls in terms of intraoperative fentanyl consumption (<em>P</em> .001) and pain control (<em>P</em> &lt;.001).</div></div><div><h3>Conclusions</h3><div>SIPB and QLB showed adequate postoperative pain control, good quality of recovery and lower fentanyl consumption, especially compared to the control group.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 6","pages":"Article 501728"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212855","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":"Intubación traqueal con videolaringoscopia: superando la barrera del lenguaje","authors":"M.A. Fernández-Vaquero ,&nbsp;A.A.J. van Zundert ,&nbsp;M.A. Gómez-Ríos","doi":"10.1016/j.redar.2024.501676","DOIUrl":"10.1016/j.redar.2024.501676","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 6","pages":"Article 501676"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212258","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":"Rotura traqueal consecuencia de hematoma intramural aórtico sobreinfectado en prótesis de aorta ascendente","authors":"E. Pereda González,&nbsp;A. Cervera Puchades,&nbsp;M.J. Hernández-Cádiz,&nbsp;J. Moreno Pachón,&nbsp;J. de Andrés Ibáñez","doi":"10.1016/j.redar.2024.06.005","DOIUrl":"10.1016/j.redar.2024.06.005","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 6","pages":"Article 101646"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212261","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":"Monitorización de la nocicepción mediante índice NoL y su implicación en la reducción de las complicaciones en cirugía abdominal laparoscópica (estudio SIMONE): protocolo de un estudio prospectivo, multicéntrico, observacional de cohortes","authors":"A.M. Pascual-Bellosta ,&nbsp;C. Aragón-Benedí ,&nbsp;S.M. Ortega-Lucea ,&nbsp;L. Mínguez-Braulio ,&nbsp;M. Buey-Aguilar ,&nbsp;A. Abad-Gurumeta ,&nbsp;E. Tamayo-Gómez ,&nbsp;J. Martinez-Ubieto ,&nbsp;Grupo de Estudio SIMONE","doi":"10.1016/j.redar.2025.501729","DOIUrl":"10.1016/j.redar.2025.501729","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Nociception monitoring allows for the titration of opioid drugs in the intraoperative period in order to avoid under- and overdosing of these drugs and their side effects in the patient's postoperative period. For this reason, a study has been designed with the aim of establishing whether the usefulness of the NoL® (Nociception Level) device for adequate intraoperative nociception monitoring can reduce postoperative complications.</div></div><div><h3>Material and methods</h3><div>Multicentre, observational, prospective cohort study that will include patients who underwent laparoscopic abdominal surgery under balanced general anaesthesia during one year in different hospital centres in order to assess the incidence of early and late postoperative complications and their relationship with the monitoring of nociception studied through the NoL device. Intraoperative pain management will be based on NoL values (visible NoL group) or hemodynamic parameters according to usual clinical practice (non-visible NoL group).</div></div><div><h3>Results</h3><div>Approval has been obtained from the Autonomous Research Ethics Committee of Aragon (C.I. EPA23/026, 19 April 2023). SIMONE study was registered at <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span> on 30 May 2024 (Identifier: NCT06437743).</div></div><div><h3>Conclusions</h3><div>The overall data will be published in peer-reviewed journals. The relevance of the SIMONE study lies in being the first nationwide to comprehensively evaluate opioid dosing, postoperative pain, early and late postoperative complications, and the length of hospital stay. A significant reduction in the incidence of postoperative complications such as nausea and vomiting is expected in the group with visible NoL monitoring.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 6","pages":"Article 501729"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212191","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":"Efecto de la cafeína en la frecuencia respiratoria, el tiempo de recuperación y la actividad de onda cerebral durante la emergencia de la anestesia con sevoflurano en ratas","authors":"B.M. Çam ,&nbsp;H. Topçu ,&nbsp;E.S. Tiryaki ,&nbsp;G. Arslan","doi":"10.1016/j.redar.2025.501730","DOIUrl":"10.1016/j.redar.2025.501730","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether caffeine affects the respiratory rate, recovery time and brain slow-wave (theta and delta) activities during the recovery from sevoflurane anesthesia in rats.</div></div><div><h3>Methods</h3><div>Male Sprague-Dawley rats (n<!--> <!-->=<!--> <!-->16) were randomly divided into 2 groups: control (saline) and caffeine(75<!--> <!-->mg/kg). After tripolar electrode implantation, rats were placed in an anesthesia chamber and brain electrocorticographic wave activities began to be recorded. Anesthesia induction was provided with sevoflurane at 4% concentration (4<!--> <!-->L/min O₂) for 5<!--> <!-->min and when all of the rats became unconscious, sevoflurane concentration was reduced to 3% (4<!--> <!-->L/min O₂) for anesthesia maintenance. Saline or caffeine was intraperitoneally injected 10<!--> <!-->min before discontinuing the anesthesia. After the sevoflurane was cut off, the rats were removed from the gas-tight box and the durations of the respiratory rate, the tail clamp and the righting reflex (full-recovery) were observed and noted. Theta and delta wave numbers and amplitude (above basal activity) as well as the number of theta oscillations were calculated from electrocorticographic recordings.</div></div><div><h3>Results</h3><div>Caffeine administration increased the respiratory rate during sevoflurane anesthesia; however, no significant difference was seen compared to the control group during the full recovery period. The durations of the tail clamp and the righting reflex, theta oscillations, and slow-wave number and amplitude were decreased with the injection of caffeine.</div></div><div><h3>Conclusions</h3><div>Acute administration of caffeine accelerates the recovery from sevoflurane anesthesia by affecting the central nervous system. Considering that prolongation of the recovery period from anesthesia increases postoperative delirium, intraoperative caffeine use may reduce risks.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 6","pages":"Article 501730"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212192","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":"Lesión renal aguda postoperatoria en cirugía mayor abdominal. Utilidad del biomarcador urinario [TIMP-2] × [IGFBP7] (NephroCheck®)","authors":"A. Lara-Jiménez ,&nbsp;P. Monedero ,&nbsp;G. Echarri","doi":"10.1016/j.redar.2025.501853","DOIUrl":"10.1016/j.redar.2025.501853","url":null,"abstract":"<div><h3>Background</h3><div>The urinary biomarker [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] enables the prediction of postoperative acute kidney injury (PO-AKI). Our study aimed to assess the incidence of PO-AKI in high-risk patients undergoing major abdominal surgery and to evaluate the impact of implementing KDIGO renal optimization measures in those with renal stress identified by [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7].</div></div><div><h3>Materials and methods</h3><div>This was a prospective study including 182 patients who underwent major abdominal surgery. Perioperative data, [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] levels, and the implementation of KDIGO renal protection strategies in the ICU were collected. Predictors of PO-AKI were identified through multivariate analysis.</div></div><div><h3>Results</h3><div>The overall incidence of PO-AKI was 25.3%, reaching 42.7% in ICU patients. [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] showed moderate predictive ability (AUROC<!--> <!-->=<!--> <!-->.74), with a PO-AKI incidence of 47.5% in patients with elevated levels. Despite the implementation of KDIGO measures in the ICU, the incidence of PO-AKI in patients with elevated [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] was 65.6%. In multivariate analysis, the main predictors of PO-AKI were elevated [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] (OR<!--> <!-->=<!--> <!-->6.3; 95%<!--> <!-->CI: 2.6-15.6; <em>P</em> <!-->&lt;<!--> <!-->.001), male sex (OR<!--> <!-->=<!--> <!-->6.1; 95%<!--> <!-->CI: 1.9-19.6; <em>P</em> <!-->=<!--> <!-->.002), and ICU admission (OR<!--> <!-->=<!--> <!-->4.5; 95%<!--> <!-->CI: 1.5-13.6; <em>P</em> <!-->=<!--> <!-->.009).</div></div><div><h3>Conclusions</h3><div>PO-AKI is common after major abdominal surgery, particularly in ICU patients. The [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] biomarker allows for early identification of at-risk patients, although the implementation of KDIGO measures in the ICU did not significantly reduce its incidence.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501853"},"PeriodicalIF":0.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722121","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":"Actualización en el tratamiento del dolor neuropático del Grupo de Interés Especial en Dolor Neuropático de la Asociación Internacional para el Estudio del Dolor","authors":"A. Alcántara Montero","doi":"10.1016/j.redar.2025.501856","DOIUrl":"10.1016/j.redar.2025.501856","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501856"},"PeriodicalIF":0.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722118","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":"Variabilidad de la frecuencia cardiaca para la evaluación de la capacidad funcional en programas de rehabilitación multimodal en cirugía del adulto: Protocolo Estudio PreANI","authors":"C. Aragón-Benedí ,&nbsp;S. Ortega-Lucea ,&nbsp;A. Pascual-Bellosta ,&nbsp;M. Corcoy-Bidasolo ,&nbsp;J. Longas-Vailen ,&nbsp;J. Martinez-Ubieto ,&nbsp;Grupo de Investigación Estudio PreANI","doi":"10.1016/j.redar.2025.501849","DOIUrl":"10.1016/j.redar.2025.501849","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Despite the implementation of multimodal rehabilitation programs, postoperative complications are common in some surgeries, and patient recovery is not as rapid as expected. This study was designed to evaluate whether postoperative outcomes can be improved by assessing preoperative functional reserve and frailty on the basis of heart rate variability, specifically energy and the ANIm value, in patients following prehabilitation programs.</div></div><div><h3>Material and method</h3><div>Prospective, observational cohort study that will include patients undergoing colorectal oncology surgery within a multimodal rehabilitation program. Patients will be monitored with the ANI device at 2 time points: initial (first pre-anaesthesia consultation, 4 weeks before surgery) and second consultation (1 week before surgery). Data will be collected on heart rate variability, energy, and ANIm values, cardiopulmonary exercise test scores, and other parameters.</div></div><div><h3>Results</h3><div>We will analyse the correlation between heart rate variability indices and current functional assessment parameters, physiological reserve, and frailty (ASA scale, 6-minute walk test, MUST scale, and Clinical Frailty Scale). Our hypothesis is that higher energy levels will correlate with better postoperative outcomes, fewer complications, and shorter hospital stays. Statistical analysis will respect all principles of confidentiality and privacy. The results will be published in peer-reviewed journals.</div></div><div><h3>Conclusions</h3><div>This study aims to provide a new tool for assessing frailty and functional reserve in surgical patients as a means of improving prehabilitation programs and postoperative outcomes.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501849"},"PeriodicalIF":0.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721976","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":"Factores asociados a la dehiscencia de anastomosis postoperatoria y comparación de 4 escalas de predicción en cirugía colorrectal","authors":"J.M. Nieves-Alonso,&nbsp;L.A. Gómez Arredondo,&nbsp;P. Maestre Serantes,&nbsp;C. Martín Martín,&nbsp;F. Guitart de la Lastra,&nbsp;F. Ramasco Rueda","doi":"10.1016/j.redar.2025.501852","DOIUrl":"10.1016/j.redar.2025.501852","url":null,"abstract":"<div><h3>Introduction</h3><div>Anastomotic leakage is a serious post-colorectal surgery complication, and has an incidence ranging from 2.8% to 30%. Identifying risk factors and evaluating prediction scores could optimize perioperative management. This study analyses factors associated with dehiscence and compares the predictive capacity of four scales: ASA, CCI, RCRI and AUB-HAS2.</div></div><div><h3>Methods</h3><div>Retrospective observational study in 182 patients undergoing colorectal surgery with anastomosis in a Spanish tertiary hospital (2018-2020). Clinical and perioperative data were collected, and the ASA, CCI, RCRI and AUB-HAS2 scores were calculated. Risk factors were analysed using multivariate logistic regression, and predictive capacity was assessed with ROC curves.</div></div><div><h3>Results</h3><div>Leakage occurred in 13.2% of cases. In the multivariate analysis, heart failure (OR: 4.14; 95% CI: 1.14-13.77) and laparotomy (OR: 2.67; 95% CI: 1.07-6.60) were significantly associated with dehiscence. None of the scales predicted this complication. The AUB-HAS2 and CCI scales were associated with 30-day mortality (AUC: 0.81 and 0.74, respectively), and the CCI predicted the need for organ support (AUC: 0.71).</div></div><div><h3>Conclusion</h3><div>Heart failure and laparotomy are independent risk factors for anastomotic leakage. Although none of the scales predicted this complication, the AUB-HAS2 and CCI were useful in stratifying postoperative mortality. This highlights the importance of personalized assessment.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501852"},"PeriodicalIF":0.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722120","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":"Guía clínica y plan estratégico para la prevención, el diagnóstico y el tratamiento del delirium: Proyecto Delirium Zero","authors":"O. de la Varga-Martínez ,&nbsp;R. Badenes ,&nbsp;C. Gordaliza ,&nbsp;S. de Miguel Manso ,&nbsp;G.E. Landázuri Castillo ,&nbsp;C. Armenteros Aragon ,&nbsp;M. Fernández Castro ,&nbsp;A.B. Martin Santos ,&nbsp;R. Lopez Herrero ,&nbsp;R. Navarro Pérez ,&nbsp;A. Abad Gurumeta ,&nbsp;M. Varela Duran ,&nbsp;M. Heredia Rodriguez ,&nbsp;E. Tamayo Gómez ,&nbsp;revisores externos","doi":"10.1016/j.redar.2025.501805","DOIUrl":"10.1016/j.redar.2025.501805","url":null,"abstract":"<div><div>The aim of this clinical practice guideline is to provide a rationale for the implementation of the Zero Delirium Project (ZDP) - a series of recommendations for patients in special critical care units (SCCU). The recommendations were developed by a group of anaesthesiologists from around Spain, and were reviewed by the Scientific Committee of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy.</div><div>Delirium is an acute, fluctuating, multifactorial syndrome characterised by inattention, disorganised thinking, and an altered level of consciousness. It may affect up to 56% in patients during their stay in critical care, and is important because many SCCUs have not yet introduced routine delirium screening, treatment and prevention strategies. Staff that are able to recognise and diagnose delirium can prevent it, treat it and reduce its incidence, which in turn reduces morbidity, mortality and costs. The ZDP was created with this aim in mind.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501805"},"PeriodicalIF":0.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721974","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}