Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Manejo anestésico para bilobectomía pulmonar en un paciente con lobectomía contralateral previa y laringuectomía total con traqueostomía","authors":"R. Iraburu,&nbsp;J. Fernández,&nbsp;C. Francisco,&nbsp;M. Taboada","doi":"10.1016/j.redar.2025.502026","DOIUrl":"10.1016/j.redar.2025.502026","url":null,"abstract":"<div><div>Pulmonar lobectomy by video-assisted thoracoscopic surgery (VATS) usually requires collapse of the operative lung and ventilation of the contralateral lung only. The complexity of anaesthetic management in such procedures is further increased by patient comorbidities and previous pathologies. We report the case of a patient scheduled for right lower lobectomy by VATS with a history of previous left lower lobectomy and total laryngectomy with permanent tracheostomy after a glottic carcinoma. A left-sided double-lumen tube was used in combination with a bronchial blocker in order to allow selective ventilation of the right upper lobe should intraoperative hypoxaemia occur.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 6","pages":"Article 502026"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140986","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 orotraqueal en paciente despierto utilizando el videolaringoscopio C-MAC D-Blade en pacientes de cáncer con vía aérea difícil anticipada: una experiencia unicéntrica","authors":"D. Abdellatif Elebedy,&nbsp;A. Medhat Mohasseb,&nbsp;E. Mohamed Mokbel,&nbsp;M. Mohammed Alseoudy","doi":"10.1016/j.redar.2026.502130","DOIUrl":"10.1016/j.redar.2026.502130","url":null,"abstract":"<div><h3>Background and aims</h3><div>Managing difficult airways in cancer patients remains a significant challenge for anesthetists worldwide due to the risk of serious complications. Therefore, this study aimed to evaluate the feasibility of awake orotracheal intubation using the C-MAC D-Blade in cancer patients with predicted difficult airways undergoing elective surgery under general anesthesia.</div></div><div><h3>Method</h3><div>We enrolled 180 cancer patients with difficult airways, as assessed by the El-Ganzouri Risk Index. Awake orotracheal intubation was performed using the C-MAC D-Blade, with topical local anesthesia and sedation. The primary outcome was the first-attempt intubation success rate. Secondary outcomes included the total intubation time, hemodynamic changes, patient responses, complications, and the ease of the procedure, assessed by both anesthesiologists and patients using a visual analog scale (VAS).</div></div><div><h3>Results</h3><div>First-attempt intubation was successful in 89.4% of patients (n<!--> <!-->=<!--> <!-->161), 8.3% (n<!--> <!-->=<!--> <!-->15) required a second attempt, and 2.2% (n<!--> <!-->=<!--> <!-->4) required a third attempt. No failed intubations were recorded. The mean intubation time with its standard deviation was 40.8<!--> <!-->±<!--> <!-->9.01<!--> <!-->seconds. At one and two minutes after intubation, heart rate and mean arterial blood pressure increased significantly from baseline values (p<!--> <!-->&lt;<!--> <!-->0.001). Tooth damage occurred in three patients, bleeding gums in seven patients, and tissue edema in four patients. The median VAS score for both anesthesiologists and patient satisfaction was 9, indicating high procedural feasibility. Additionally, a statistically significant positive correlation was observed between the number of intubation attempts and cough severity (p<!--> <!-->=<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>Awake video-laryngoscopic intubation using the C-MAC D-Blade achieved a high first-attempt success rate (89.4%) with minimal complications in cancer patients with predicted difficult airways. These results suggest it is a safe and effective option when careful assessment, adequate topical anesthesia, and appropriate sedation are ensured, although comparative studies are needed to better define its role.</div><div>Clinical Trial Registry: Registered at clinicaltrial.gov registry system (clinical trial identifier: PACTR202408730457046).</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 6","pages":"Article 502130"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140982","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":"Protocolo del estudio KETOMED: cetonemia y agitación al despertar en un estudio multicéntrico","authors":"R. Poves Álvarez ,&nbsp;E. López-Santín ,&nbsp;B. Martínez-Rafael ,&nbsp;R. Badenes ,&nbsp;M. Varela ,&nbsp;A. Abad-Gurumeta ,&nbsp;S. de Miguel-Manso ,&nbsp;M.A. Miñambres-Villar ,&nbsp;E. Carrasco Serrano ,&nbsp;A. Fernández-Urbón ,&nbsp;E. Tamayo ,&nbsp;E. Gómez Pesquera","doi":"10.1016/j.redar.2026.502131","DOIUrl":"10.1016/j.redar.2026.502131","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergence delirium (ED) is a frequent complication in children following general anaesthesia, affecting up to a third of paediatric patients. Its multifactorial etiology suggests the metabolic state derived from preoperative fasting plays a significant role. Ketonemia, a physiological state subsequent to fasting, has been minimally investigated as an independent risk factor for ED. The KETOMED study aims to determine whether preoperative ketonemia is independently associated with the development of ED in the paediatric population.</div></div><div><h3>Material and methods</h3><div>Multicenter observational study, pediatric patients under general anesthesia. Participants will be grouped based on the presence or absence of ED, defined using the Pediatric Anesthesia Emergence Delirium (PAED) scale. Inclusion and exclusion criteria were based on age, surgical type, and anaesthesia protocol. Main outcome will be ED and its association with ketonemia levels. Secondary outcomes included other clinical and sociodemographic risk factors and parental satisfaction.</div></div><div><h3>Discussion</h3><div>Although significant literature highlights the beneficial role of ketone bodies in cerebral development, a knowledge gap remains regarding their influence as a potentially adverse factor in the induction of ED. KETOMED addresses this through a robust prospective design and validated tools, including the Spanish translation of the PAED scale.</div></div><div><h3>Conclusion</h3><div>KETOMED is expected to establish evidence supporting the implementation of low-cost preoperative ketonemia screening. The results have the potential to guide clinical practice regarding fasting management and clear fluid administration, ultimately aiming to reduce the incidence of ED and improve the quality and safety of paediatric anaesthetic recovery.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 6","pages":"Article 502131"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140983","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 en un paciente pediátrico con síndrome de Sengers. A propósito de un caso","authors":"M.A. Perelló,&nbsp;F.J. Bellafont,&nbsp;E. Pujol-Ayach,&nbsp;M. Alegret","doi":"10.1016/j.redar.2025.502024","DOIUrl":"10.1016/j.redar.2025.502024","url":null,"abstract":"<div><div>Sengers syndrome is an autosomal recessive mitochondrial myopathy caused by mutations of the acylglycerol kinase gene, which leads to an abnormal musculoskeletal and myocardial lipid and glycogen accumulation. It is characterized by congenital cataracts, hypertrophic cardiomyopathy, skeletal myopathy and lactic acidosis (especially under stress condition). Therefore, cataract surgery might be indicated. Currently there is no treatment or management formalised for this disease, meaning it is a challenge in clinical practice. We introduce a case of perioperative anaesthetic management on a patient with Sengers syndrome, considering its interest as it is one of the first known cases undergoing general anaesthesia.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502024"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652978","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":"Parada cardiorrespiratoria perioperatoria en la paciente obstétrica","authors":"M. Astete ,&nbsp;H.J. Lacassie ,&nbsp;A. Gálvez","doi":"10.1016/j.redar.2026.502037","DOIUrl":"10.1016/j.redar.2026.502037","url":null,"abstract":"<div><div>Perioperative cardiopulmonary arrest (CPA) in the obstetric patient is a rare but devastating complication, representing a significant clinical challenge due to the speed with which it threatens the lives of the mother and fetus. Although, compared to the general population, obstetric patients have a lower risk due to their youth and fewer comorbidities, recent records show an increase in the incidence of CPA in this group. Anesthetic factors are key, especially when general anesthesia is used, and unexpected conversion from neuraxial blocks poses an additional risk. Success in the management of CPA critically depends on early recognition and a coordinated, structured approach, where understanding the causes and maternal physiology is essential. Emphasizing education specifically dedicated to obstetric CPA is a priority, as conventional approaches like basic and advanced cardiac life support have proven insufficient for the particularities of this setting. To optimize outcomes, it is recommended to train skilled multidisciplinary teams, implement adapted protocols, and carry out timely interventions such as <em>perimortem</em> cesarean section. Effective communication between teams and the application of advanced support measures, always considering maternal and fetal well-being, are decisive factors for prognosis. In summary, perioperative CPA in obstetrics requires specific protocols, ongoing knowledge updates and simulation, with the primary goal of reducing maternal mortality and improving neonatal outcomes in one of the most critical scenarios faced by healthcare teams.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502037"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652971","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":"Respuesta a Sethuraman et al. con respecto al artículo «Comparación de la inyección única de morfina neuroaxial y el bloqueo en el plano del músculo erector de la columna en la calidad de la recuperación tras las cirugías gastrointestinales abiertas mayores»","authors":"A. Choudhary ,&nbsp;S. Singh","doi":"10.1016/j.redar.2025.502001","DOIUrl":"10.1016/j.redar.2025.502001","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502001"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652972","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":"Relación entre excursión sistólica del plano anular mitral y fracción de eyección del ventrículo izquierdo utilizando el método de Simpson modificado con ecografía cardiaca en el punto de atención: estudio analítico observacional","authors":"N. Kumar,&nbsp;K. Arya,&nbsp;M. Pandey","doi":"10.1016/j.redar.2026.502088","DOIUrl":"10.1016/j.redar.2026.502088","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to find the relationship between MAPSE and LVEF by modified Simpson's method using point of care cardiac ultrasound.</div></div><div><h3>Design</h3><div>Prospective observational study.</div></div><div><h3>Setting</h3><div>Intensive care unit.</div></div><div><h3>Patients</h3><div>Seventy-five patients admitted to the intensive care unit were recruited for determining the relationship between MAPSE and LVEF by modified Simpson's method. It was validated in the second part in another 75 patients by comparing the result obtained from modified Simpson's method and the previously derived equation.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Measurements</h3><div>MAPSE, LVEF from modified Simpson's method in part I. An equation was derived from a linear relationship between the two. In part II, the derived equation for calculation of LVEF from MAPSE was validated with respect to a previously described equation and LVEF obtained by modified Simpson's method. Bias and precision were calculated. Time taken for both the procedures was also noted.</div></div><div><h3>Results</h3><div>MAPSE showed a strong correlation with LVEF calculated by modified Simpson's method. The linear equation obtained was LVEF<!--> <!-->=<!--> <!-->3.27 x MAPSE (mm)<!--> <!-->+<!--> <!-->18.79 (ρ=0.761, R² <!-->=<!--> <!-->0.520). Time taken for calculation of MAPSE was quicker (51.47<!--> <!-->± 11.18s) as compared to that by modified Simpson's method (192.27<!--> <!-->±<!--> <!-->31.93s; p<!--> <!-->&lt;<!--> <!-->0.001). The equation was found to be 89.33% accurate. A MAPSE of 10.325<!--> <!-->mm, predicts EF<!--> <!-->&gt;50% with a sensitivity of 90.7% and 90.6% specificity.</div></div><div><h3>Conclusion</h3><div>MAPSE correlates well with the EF measured by modified Simpson's method. It is faster and provides an accurate estimation of ejection fraction.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502088"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652982","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":"Posición tras la anestesia espinal y su impacto en la hemodinámica, altura del bloqueo y comodidad en el parto por cesárea: ensayo aleatorizad oculto para el evaluador","authors":"A. Mohamady Eldemrdash,&nbsp;I. Elabd Hassan,&nbsp;A. Youssef Mohamed,&nbsp;H.M. Ahmed Raslan","doi":"10.1016/j.redar.2026.502089","DOIUrl":"10.1016/j.redar.2026.502089","url":null,"abstract":"<div><h3>Background</h3><div>Maternal hypotension is common during spinal anesthesia for cesarean delivery and is influenced by patient position. Positioning also affects sensory block height, which determines visceral analgesia. This study compared immediate supine, sitting, and semi-sitting positions to identify the optimal balance between cardiovascular stability and surgical anesthesia.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, 216 ASA II term parturients scheduled for cesarean delivery under spinal anesthesia were assigned to three groups (n<!--> <!-->=<!--> <!-->72). Group A received immediate supine positioning, Group B sat for three minutes, and Group C assumed semi-sitting for three minutes. All received 2.5<!--> <!-->mL of 0.5% hyperbaric bupivacaine. The primary outcome was maternal hypotension; secondary outcomes included block height, intraoperative discomfort, vasopressor use, and neonatal Apgar scores.</div></div><div><h3>Results</h3><div>Hypotension occurred most in Group A (65.3%), followed by Group C (47.2%) and Group B (33.3%) (p<!--> <!-->&lt;<!--> <!-->0.001). The supine group had 3.79 times higher odds of hypotension compared with sitting. Ephedrine use was greatest in Group A (14.5<!--> <!-->±<!--> <!-->3.2<!--> <!-->mg) and least in Group B (8.1<!--> <!-->±<!--> <!-->2.3<!--> <!-->mg). Median block height was T3 in Group A, T5 in Group C, and T6 in Group B. Intraoperative discomfort was highest in Group B (22.2%) compared with Group C (12.5%) and Group A (5.6%) (p<!--> <!-->=<!--> <!-->0.009). Hypotension correlated with nausea, most frequent in Group A (19.4%). Neonatal Apgar scores were ≥8 at 1 and 5<!--> <!-->minutes in all groups.</div></div><div><h3>Conclusion</h3><div>Maternal position after spinal anesthesia significantly influences hemodynamics and block height. Sitting reduces hypotension but risks lower block and discomfort, while semi-sitting provides a favorable compromise.</div><div>Registration for the trial [NCT06857162].</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502089"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652986","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":"Coherencia hemodinámica en 2025: un año de revisión del grupo de Fluidoterapia y Hemodinámica de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR)","authors":"J. Ripollés-Melchor ,&nbsp;A.V. Espinosa ,&nbsp;M.I. Monge-García ,&nbsp;M.J. Colomina ,&nbsp;P. Galán-Menéndez ,&nbsp;G. Yanes-Vidal ,&nbsp;R. Navarro-Pérez ,&nbsp;C. Aldecoa ,&nbsp;S. Montesinos-Fadrique ,&nbsp;J.L. Jover-Pinillos ,&nbsp;P. Fernández-Valdés-Bango ,&nbsp;A. Abad-Gurumeta ,&nbsp;I. Jiménez-López ,&nbsp;J. García-Fernández ,&nbsp;J.V. Lorente","doi":"10.1016/j.redar.2026.502090","DOIUrl":"10.1016/j.redar.2026.502090","url":null,"abstract":"<div><h3>Background</h3><div>Haemodynamic research advanced across perioperative and critical-care medicine, with major contributions in vascular physiology, microcirculation, fluid therapy, arterial pressure targets, organ protection and the clinical performance of monitoring and artificial intelligence (AI) supported systems. Given the breadth and heterogeneity of this evidence, a coherent physiological synthesis is required.</div></div><div><h3>Methods</h3><div>Between December 2024 and December 2025, we undertook a broad, intentionally inclusive review of high-impact perioperative and critical-care journals, complemented by targeted PubMed searches centred on perfusion, arterial pressure, microcirculation and haemodynamic monitoring in adult patients. Selection was curatorial rather than exhaustive, optimization studies that materially advanced physiological understanding or challenged prevailing assumptions. Relevant trials, mechanistic studies and conceptual papers were grouped into thematic blocks and interpreted through a unified physiological lens. No formal risk-of-bias scoring was applied.</div></div><div><h3>Findings</h3><div>Macrocirculatory correction alone did not ensure microvascular or metabolic recovery. Vasoplegia, endothelial dysfunction and venous congestion repeatedly defined the limits of resuscitation, while vasopressor efficacy proved phenotype-dependent. Timing of fluid administration outweighed cumulative volume, and early-perfusion markers outperformed traditional surrogates such as lactate. Intraoperative blood pressure prediction and automation consistently reduced hypotension exposure but did not improve organ injury or complications. Renal protection advanced through biomarker-enriched prevention rather than numerical thresholds. Updated guidelines emphasised physiological coherence over fixed targets, highlighting persisting uncertainty around personalised arterial pressure goals, optimal perfusion monitoring and the integration of emerging AI systems.</div></div><div><h3>Conclusion</h3><div>The 2025 haemodynamic literature reinforces a unifying principle: numerical optimization is insufficient; clinical benefit arises only when interventions respect vascular biology, microcirculatory capacity and metabolic tolerance.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502090"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652969","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":"Técnicas de anestesia regional para el hombro con preservación del diafragma: comprender los conceptos y las aplicaciones clínicas","authors":"R.M. Sethuraman","doi":"10.1016/j.redar.2026.502038","DOIUrl":"10.1016/j.redar.2026.502038","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502038"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652984","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}