Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Manejo de la anemia preoperatoria en cáncer colorrectal y análisis de las estrategias perioperatorias Patient Blood Management","authors":"A. Bernardo Chávez,&nbsp;N. Bakhshaliyeva,&nbsp;A. Planas Roca,&nbsp;E. Alday Muñoz","doi":"10.1016/j.redar.2026.502174","DOIUrl":"10.1016/j.redar.2026.502174","url":null,"abstract":"<div><h3>Introduction and endpoints</h3><div>Preoperative anaemia is a common finding in patients with colorectal cancer (CRC) and is significantly associated with morbidity and mortality. Patient Blood Management Programs (PBM) have been developed to improve patient outcomes. This study aimed to evaluate the effectiveness of the Outpatient Blood Management Program (OBMP) in a tertiary hospital in Spain. The primary endpoint was to determine the percentage of patients who recover from anaemia after treatment at the OBMP. Additionally, correlations between preoperative anaemia, administered treatments, and surgical waiting times were analyzed.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted including 537 patients who underwent surgical intervention for CRC. Demographic data, haemoglobin values at three time points (inclusion on the surgical waiting list, preoperative, and postoperative), as well as the time intervals between inclusion on the waiting list and the performance of surgery, were collected.</div></div><div><h3>Results</h3><div>The prevalence of anaemia was 43.3% at the time of inclusion on the surgical waiting list. Of the total anaemic patients, 42% received specific treatment. Treatment at the OBMP was associated with a higher recovery rate (37%) and a more significant increase in haemoglobin (1.35<!--> <!-->g/dl IC_95% [0.7-2.1] vs. 0.4<!--> <!-->g/dl IC_95% [0-1.6]). Preoperative anaemia was associated with longer surgical waiting times, higher incidence of transfusions, higher prevalence of postoperative anaemia, and prolonged hospital stays.</div></div><div><h3>Conclusion</h3><div>The OBMP offers an opportunity to improve the management of anaemia in patients undergoing surgery for CRC; however, it requires interdisciplinary coordination to minimize its impact on surgical waiting times.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 7","pages":"Article 502174"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647589","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":"Tests viscoelásticos: una herramienta imprescindible para un sistema sanitario preparado","authors":"S.M. Veiras del Río,&nbsp;grupo redactor del Documento de Perspectiva Multidisciplinar sobre el Uso de Tests Viscoelásticos en la Práctica Clínica, partes I y II","doi":"10.1016/j.redar.2026.502047","DOIUrl":"10.1016/j.redar.2026.502047","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 7","pages":"Article 502047"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148646829","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 terapéutica de betalactámicos en pacientes críticos con sepsis: protocolo del ensayo clínico OPTIBETA","authors":"I. Varela Rey,&nbsp;S.M. Díaz Prado,&nbsp;M.Á. Gómez-Ríos","doi":"10.1016/j.redar.2026.502165","DOIUrl":"10.1016/j.redar.2026.502165","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a leading cause of morbidity and mortality among hospitalized patients and is associated with intensive use of β-lactam antibiotics. These drugs show time-dependent pharmacodynamics and high pharmacokinetic variability in this population, making it difficult to achieve therapeutic levels. Therapeutic drug monitoring (TDM) may optimize dosing, but its routine clinical implementation remains limited.</div></div><div><h3>Objective</h3><div>To evaluate whether individualized β-lactam dosing guided by TDM reduces time to full clinical recovery compared with standard dosing in hospitalized patients with sepsis (ICU and ward).</div></div><div><h3>Methods</h3><div>OPTIBETA is a pragmatic, randomized, controlled, open-label clinical trial with blinded outcome assessment to be conducted at a tertiary hospital in Spain. Adult patients (≥18 years) admitted to the intensive care unit or infectious diseases ward with sepsis will be included. Participants will be randomized 1:1 to either a TDM-guided dosing arm (dose adjustments according to PK/PD targets) or a standard dosing arm. Clinical, microbiological, and pharmacological outcomes will be collected. The primary endpoint is time to complete clinical cure. Secondary outcomes include overall survival, microbiological cure, ICU and hospital length of stay, adverse events, and achievement of PK/PD targets. The estimated sample size is 198 patients.</div></div><div><h3>Expected results</h3><div>We hypothesize that TDM-guided dosing will reduce time to clinical cure, improve overall outcomes, and decrease adverse events compared with standard dosing.</div></div><div><h3>Conclusions</h3><div>OPTIBETA will provide high-quality evidence on the role of β-lactam TDM in hospitalized patients with sepsis and may support its inclusion in antimicrobial stewardship programs.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 7","pages":"Article 502165"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647588","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 del plexo lumbar ecoguiado con abordaje tipo Shamrock: técnica dentro del plano frente a técnica nueva fuera del plano","authors":"K. Ökmen,&nbsp;G. Güler,&nbsp;G.K. Ülker","doi":"10.1016/j.redar.2026.502128","DOIUrl":"10.1016/j.redar.2026.502128","url":null,"abstract":"<div><h3>Background</h3><div>A lumbar plexus block (LPB) can be used with different techniques for anesthesia and postoperative analgesia during femoral surgery. This study aimed to compare in-plane and out-of-plane needle guidance methods using the Shamrock position.</div></div><div><h3>Methods</h3><div>Forty-two patients scheduled for surgery due to femoral neck fractures were included in this randomized controlled study. The Shamrock position was used for lumbar plexus visualization. Patients were randomized into two groups: one group received a LPB using the in-plane technique (n<!--> <!-->=<!--> <!-->20), and the other group received LPB using the out-of-plane technique (n<!--> <!-->=<!--> <!-->20). The primary outcome measure was Block procedure time. Secondary outcomes included the number of needle insertions and redirections, needle depth (cm), minimal nerve stimulation (mA), sensory and motor block levels, and degree of epidural spread.</div></div><div><h3>Results</h3><div>No statistically significant difference was found between the groups in block procedure times (p<!--> <!-->&gt;<!--> <!-->0.05). The number of insertions and the number of needle redirections were significantly lower in the out-of-plane group compared to the in-plane group (p<!--> <!-->=<!--> <!-->0.005). The needle depth was significantly greater in the in-plane group compared to the out-of-plane group (6.5<!--> <!-->±<!--> <!-->1.1<!--> <!-->cm vs 5.1<!--> <!-->±<!--> <!-->0.8<!--> <!-->cm, p<!--> <!-->=<!--> <!-->0.001). No difference was found in sensory and motor block times (p<!--> <!-->&gt;<!--> <!-->0.05). There was no difference in the number of patients with epidural spread or in the observed complications (p<!--> <!-->&gt;<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>The out-of-plane technique demonstrated similar efficacy to the in-plane method in Shamrock position. The out-of-plane technique can be used as an alternative option for elderly patients who have difficulty with needle guidance.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 6","pages":"Article 502128"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140879","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":"Determinantes sociales asociados a estilos de vida poco saludables en las personas mayores de 60 años con dolor crónico musculoesquelético","authors":"A. Loyola-Pinchetti ,&nbsp;M. Jara-Manríquez ,&nbsp;T. Vera-Vera ,&nbsp;A. Venegas-Rodríguez ,&nbsp;C. Santander ,&nbsp;M. Moena-León ,&nbsp;Á. Besoain-Saldaña ,&nbsp;C. Cruz-Montecinos ,&nbsp;R. Núñez-Cortés","doi":"10.1016/j.redar.2026.502129","DOIUrl":"10.1016/j.redar.2026.502129","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic musculoskeletal pain in older adults is associated with unhealthy lifestyles, possibly influenced by social determinants of health (SDH).</div></div><div><h3>Objective</h3><div>To identify the association between SDH and unhealthy lifestyles in older adults with chronic musculoskeletal pain.</div></div><div><h3>Material and methods</h3><div>A cross-sectional study was conducted. A structured survey was administered to assess SDH (gender, educational level, income, availability of green spaces, rurality, multimorbidity, and cohabitation) and lifestyles (physical activity: IPAQ; sleep quality: abbreviated PSQI; perceived stress: PSS-4; adherence to the Mediterranean diet: MedDiet Score). Mann-Whitney U tests and multivariate logistic regression models were applied.</div></div><div><h3>Results</h3><div>One hundred people were included (mean age 69.0<!--> <!-->±<!--> <!-->9.8; 83% women). Forty percent were physically inactive, 71% had poor sleep quality, 36% had high perceived stress, and 76% had low adherence to the Mediterranean diet. Female sex was associated with poorer sleep quality (<em>P</em>=.023), absence of green areas with less weekly walking time (<em>P</em>=.042), multimorbidity with higher perceived stress (<em>P</em>=.039), and low educational level with lower adherence to the Mediterranean diet (<em>P</em>=.022). These findings were maintained in logistic regression models adjusted for age, body mass index, and pain intensity.</div></div><div><h3>Conclusions</h3><div>Being female, having lower educational attainment, living without access to green areas, and presenting multimorbidity were associated with poorer sleep, decreased dietary adherence, lower physical activity, and higher stress, respectively. These findings correspond to associations observed in a cross-sectional design and do not allow causal relationships to be established.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 6","pages":"Article 502129"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140880","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 metamorfosis de la evidencia: predicciones para la próxima década","authors":"R. Poves-Álvarez ,&nbsp;E. Tamayo","doi":"10.1016/j.redar.2026.502050","DOIUrl":"10.1016/j.redar.2026.502050","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 6","pages":"Article 502050"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140881","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":"Docencia y formación en anestesia regional en la era ecográfica","authors":"P. Diéguez García ,&nbsp;S. López Álvarez ,&nbsp;C. del Olmo","doi":"10.1016/j.redar.2026.502136","DOIUrl":"10.1016/j.redar.2026.502136","url":null,"abstract":"<div><div>The widespread adoption of ultrasound in regional anaesthesia has profoundly changed both clinical practice and the way this field should be taught. The current challenge is not merely the availability of more blocks or approaches, but preventing the growing number of variants and terms from leading to fragmented learning and inconsistent clinical decision-making. From this standpoint, competence should be viewed as the integration of clinical judgement, evidence-informed selection, pharmacological knowledge, safe technical performance, proper documentation, patient communication, and follow-up. Within such a framework, simulation should occupy a central place in training pathways not only during residency, but also in the continuing education of professionals involved in regional anaesthesia, because it supports competency-based progression and allows more objective assessment of learning outcomes. Accreditation processes promoted by scientific societies may help standardise practice, provided that adequate educational resources and teaching capacity are available for real implementation. In high-pressure clinical settings with frequent staff turnover, standardisation of training and care processes does not oppose clinical individualisation, but rather makes it safer, more reproducible, and better adapted to each patient's characteristics.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 6","pages":"Article 502136"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140877","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":"Reflexiones sobre: «Comparación de la inyección única neuroaxial de morfina y el bloqueo en el plano del músculo erector de la columna en la calidad de la recuperación tras cirugías gastrointestinales abiertas mayores»","authors":"R.M. Sethuraman,&nbsp;R. Aravindan","doi":"10.1016/j.redar.2026.502045","DOIUrl":"10.1016/j.redar.2026.502045","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 6","pages":"Article 502045"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140985","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":"Las rondas de seguridad como herramienta para la mejora de la calidad y seguridad en unidades de reanimación: un estudio cuasiexperimental","authors":"J.J. López-Picazo Ferrer ,&nbsp;I. Vidal-Abarca Gutiérrez ,&nbsp;P. Doménech Asensi ,&nbsp;J. Padilla Rodríguez ,&nbsp;V. Valera Gómez ,&nbsp;J.M. Marín Martínez ,&nbsp;C. Garcia Palenciano","doi":"10.1016/j.redar.2026.502120","DOIUrl":"10.1016/j.redar.2026.502120","url":null,"abstract":"<div><h3>Introduction</h3><div>Safety rounds (SR) have become an effective strategy to enhance safety culture across various healthcare settings. Surgical critical care units (SCCUs) and postanesthesia care units (PACUs) are high-risk environments where active surveillance and early risk identification are essential to ensure safe care. This study aims to evaluate the applicability and effectiveness of SR in SCCUs and PACUs, providing evidence of their impact on quality and patient safety improvement.</div></div><div><h3>Methods</h3><div>A quasi-experimental study was conducted in a tertiary-level Spanish hospital with multidisciplinary participation. A structured four-phase procedure was designed for SR implementation in SCCUs and PACUs. Twelve key safety indicators were assessed through direct observation and document review using lot quality assurance sampling.</div></div><div><h3>Results</h3><div>Six SRs were conducted between 2022 and 2024. A progressive improvement in indicator compliance was observed, with non-compliance decreasing from 45% in the first round to 0% in the fourth. Indicators such as “Zero Pneumonia” and “Zero Resistance” showed recurrent difficulties, highlighting critical areas requiring targeted interventions.</div></div><div><h3>Conclusions</h3><div>SRs are an effective and adaptable tool to improve safety in SCCUs and PACUs. Their success relies on a structured approach, visible leadership, and active staff engagement, establishing them as a sustainable strategy for continuous improvement.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 6","pages":"Article 502120"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140878","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 antitrombóticos en el mundo real: estudio del impacto de no seguir el documento de consenso","authors":"M. Echeverri ,&nbsp;D. Vivas ,&nbsp;J. Igualada ,&nbsp;M. Anguita-Gámez ,&nbsp;B. Nozal-Mateo ,&nbsp;S. Gadín-López ,&nbsp;N. Bouzó-Molina ,&nbsp;F. Marín ,&nbsp;M. Anguita ,&nbsp;I. Egocheaga ,&nbsp;M.A. Esteve-Pastor ,&nbsp;R. Ferrandis ,&nbsp;en representación de los investigadores del estudio REQXAA","doi":"10.1016/j.redar.2026.502119","DOIUrl":"10.1016/j.redar.2026.502119","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>In order to standardise the periprocedural management of antithrombotic drugs, a national and multidisciplinary consensus document was drawn up in 2018. This study analyses the follow-up of this consensus and its outcome in the perioperative setting.</div></div><div><h3>Methods</h3><div>Sub-analysis of the REQXAA study (observational, prospective, multicentre with 30-day follow-up) in patients scheduled for surgery. Antithrombotic management was considered appropriate according to the consensus document. Logistic regression analysis was used to study the effect of appropriate management and other variables on the incidence of adverse thrombotic and/or haemorrhagic events (odds ratio (OR) and confidence interval (95% <span>C</span>I)).</div></div><div><h3>Results</h3><div>A total of 506 patients were included (57.5% antiplatelet therapy; 38.9% anticoagulant therapy; 3.6% dual therapy), with 50 adverse events recorded (overall incidence 9.9%), 46 of which were haemorrhagic. In 50.2% of patients, management was suboptimal, which was associated with a significant increase in adverse events (OR 2.3, 95% CI 1.2-4.2). The following factors independently increased the risk: inappropriate indication for bridging therapy (OR 3.9, 95% CI 1.9-7.9), chronic kidney disease (OR 2.0, 95% CI 1.1-3.9) and high thrombotic risk (OR 3.7, 95% CI 1.6-8.6). Patients with moderate-to-high bleeding risk and suboptimal management had a higher risk of bleeding (OR 4.4, 95% CI 1.6-11.9).</div></div><div><h3>Conclusions</h3><div>Failure to follow the consensus document for the perioperative management of antithrombotic drugs is associated with an increase in adverse events. The implementation of multidisciplinary protocols in the perioperative period, following current recommendations, could improve these outcomes.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 6","pages":"Article 502119"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140984","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}