Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"La vía aérea y el inconformismo hacia la excelencia","authors":"M.A. Gómez-Ríos , A.A.J. Van Zundert , M.A. Fernández-Vaquero","doi":"10.1016/j.redar.2025.501733","DOIUrl":"10.1016/j.redar.2025.501733","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501733"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792181","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":"Catéter intratecal tras punción dural en pacientes obstétricas: Seguridad y efectividad en la reducción de la cefalea post punción dural","authors":"G. Moreno Giménez,&nbsp;M.C. Melo Cruz,&nbsp;M. Ferrándiz Mach,&nbsp;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 24<!--> <!-->hours, 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> <!-->=<!--> <!-->.713), nor in EBP requirement (18.8% vs 31.6%; RR: 0.84; <em>P</em> <!-->=<!--> <!-->.387). Follow-up duration did not differ significantly between groups and no ITC-related complications were reported within 1<!--> <!-->month.</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}

{"title":"Utilidad de la ecografía de la vaina del nervio óptico durante la cirugía colorrectal laparoscópica","authors":"L. Alcover Navarro ,&nbsp;C.S. Romero García ,&nbsp;E. Mateo Rodríguez ,&nbsp;P. Granero Castro ,&nbsp;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}

{"title":"Manejo anestésico de un paciente con dispositivo de modulación de la contractilidad cardiaca","authors":"A. Álvarez Bartolomé ,&nbsp;Á. Mingote Lladó ,&nbsp;M. Casado Salcedo ,&nbsp;J. García Fernández","doi":"10.1016/j.redar.2024.04.006","DOIUrl":"10.1016/j.redar.2024.04.006","url":null,"abstract":"<div><div>The cardiac contractility modulation (CCM) device is an electrical therapy for the treatment of patients with moderate-severe heart failure (HF), which has been shown a small improvement in exercise tolerance and quality of life in these patients. The Guidelines about the management of implantable cardiac devices do not include any recommendations about CCM and only one article refers to the anesthetic management of these patients. We present a clinical case about the anesthetic management of a patient with this cardiac device. We believe that in the future it will be more common to find patients with similar devices in anesthesia practice.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 101636"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792830","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 músculo erector de la espina para analgesia obstétrica en el déficit de Factor XI: a propósito de un caso","authors":"P. Martín Serrano ,&nbsp;A. Ferraz Pérez ,&nbsp;C. Medina Hernández ,&nbsp;V. Prieto Hidalgo","doi":"10.1016/j.redar.2024.03.010","DOIUrl":"10.1016/j.redar.2024.03.010","url":null,"abstract":"<div><div>Factor XI (FXI) deficiency is a rare bleeding disorder characterized by a quantitative or qualitative deficiency of FXI. The symptoms are highly variable, and the severity and site of bleeding is unpredictable and does not necessarily correlate with FXI levels. FXI deficiency is classified by phenotype: bleeding or non-bleeding, depending on the clinical manifestations.</div><div>We present the case of a woman in her twenties diagnosed with FXI with a bleeding phenotype. The patient requested labour analgesia, but the haematology department contraindicated neuraxial techniques, given her history. An ultrasound-guided lumbar erector spinae plane block (ESPB) was performed, achieving pain relief after 45 minutes.</div><div>ESP block could be an alternative to consider when neuraxial analgesia is contraindicated in labour.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 101632"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792834","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":"Complicaciones asociadas al retraso en la cirugía de fractura de cadera por antiagregantes plaquetarios","authors":"V. Moratalla Sasu,&nbsp;N. Bakhshaliyeva,&nbsp;J. Fernández González,&nbsp;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 48<!--> <!-->hours 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 72<!--> <!-->hours due to antiplatelet use and those who had surgery within the first 48<!--> <!-->hours.</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 72<!--> <!-->hours in the surgery were selected. A 1:1 randomized sampling was made to obtain a control group with surgery within the first 48<!--> <!-->hours.</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}

{"title":"¿Por qué ir a ciegas si se puede visualizar la vía aérea?","authors":"A.A.J. van Zundert ,&nbsp;M.Á. Gómez-Ríos ,&nbsp;T.C.R.V. van Zundert","doi":"10.1016/j.redar.2024.501688","DOIUrl":"10.1016/j.redar.2024.501688","url":null,"abstract":"<div><div>Airway management is a critical aspect of anesthesiology, essential for ensuring patient safety during various medical interventions, including surgery, emergency care, and critical care settings. Despite advancements, difficult laryngoscopy and tracheal intubation remain significant challenges, particularly in emergency scenarios, posing risks of hypoxia, brain damage, and death. This article examines the efficacy of videolaryngoscopy (VLS) and video laryngeal mask airways (VLMA) in improving airway management outcomes compared to traditional techniques across diverse clinical environments.</div><div>We conducted a comprehensive review of literature and current practices, analyzing the advantages and limitations of VLS and VLMA. The paper highlights the importance of visualization in airway management and evaluates the effectiveness of these devices in various settings. VLS and VLMA offer several benefits over traditional direct laryngoscopy, including enhanced glottic visualization, higher first-attempt success rates, reduced rates of oxygen desaturation, and fewer adverse events. These devices provide a larger angle of view and allow for real-time monitoring, improving overall patient safety. Additionally, they serve as excellent educational tools for training anesthesiologists and other healthcare providers involved in airway management.</div><div>In emergency and critical care scenarios, the rapid and accurate placement of airway devices is crucial. VLS and VLMA facilitate quicker and more reliable intubation, reducing the likelihood of complications such as esophageal intubation or airway trauma. These technologies also allow for better teamwork and coordination as the airway view can be shared with the entire medical team.</div><div>The adoption of VLS and VLMA as standard practice in airway management can significantly enhance visualization and success rates, reducing the risk of complications. These devices should be integrated into routine clinical use to improve patient outcomes. Further research is warranted to optimize their application and explore advancements such as artificial intelligence in airway management.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501688"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792833","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":"Características clínicas e implicación pronóstica de la fibrilación auricular en el período postoperatorio de cirugía cardíaca con circulación extracorpórea","authors":"C.Y. Salinas-Ulloa ,&nbsp;R. Gopar-Nieto ,&nbsp;E. García-Cruz ,&nbsp;G. Rojas-Velasco ,&nbsp;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 (&gt;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}

{"title":"Estudio comparativo del diámetro de la vaina del nervio óptico y la puntuación Lung Ultrasound en parturientas sanas y con preeclampsia","authors":"A. Nagpal,&nbsp;M. Pandey,&nbsp;N. Kumar","doi":"10.1016/j.redar.2025.501773","DOIUrl":"10.1016/j.redar.2025.501773","url":null,"abstract":"<div><h3>Background</h3><div>Complications of preeclampsia include cerebral and pulmonary edema which strongly correlate with optic nerve sheath diameter (ONSD) and lung ultrasound score (LUSS) respectively. This study was conducted to compare ONSD and LUSS in healthy and preeclamptic parturients.</div></div><div><h3>Methods</h3><div>In this prospective observational analytical study, 35 healthy pregnant women and preeclamptic women each underwent ultrasound assessment for ONSD and LUSS (12 region lung technique). Severity of preeclampsia was noted. ROC analysis was performed to obtain a cutoff value for both ONSD and LUSS to predict complications of preeclampsia. A p-value of &lt;<!--> <!-->.05 was considered significant.</div></div><div><h3>Results</h3><div>Mean ONSD and LUSS were higher in preeclamptic compared to healthy parturients (5.06<!--> <!-->±<!--> <!-->0.46 vs 4.24<!--> <!-->±<!--> <!-->0.38<!--> <!-->mm, <em>P</em> <!-->&lt;<!--> <!-->.0001), and (5 [1-12] vs 0 [0-1.5]; p value &lt;<!--> <!-->.0001, respectively). Mean ONSD in severe pre-eclampsia (5.36<!--> <!-->±<!--> <!-->0.32<!--> <!-->mm) was significantly higher as compared to mild pre-eclampsia (4.71<!--> <!-->±<!--> <!-->0.35<!--> <!-->mm; <em>P</em> <!-->&lt;<!--> <!-->.0001). Women with severe preeclampsia had a higher LUSS as compared to the mild preeclamptics and healthy parturients. However, no difference in ONSD and LUSS between mild preeclamptics and healthy parturients was observed. A mean ONSD of &gt;<!--> <!-->4.65<!--> <!-->mm and LUSS of &gt;<!--> <!-->2 could predict preeclampsia with a sensitivity of 77.14% and 68.57% and specificity of 91.43% and 85.71% with an AUC of 0.907 and 0.806 respectively.</div></div><div><h3>Conclusion</h3><div>Both ONSD and LUSS can be used to assess severity and complications of preeclampsia. Early detection can be used to treat, guide fluid therapy and monitor response to treatment.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501773"},"PeriodicalIF":0.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134781","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 dislocación laríngea tras discectomía y fusión cervical anterior","authors":"C. Beltrán Piles,&nbsp;B. Monleón,&nbsp;R. Badenes,&nbsp;D. Tabares,&nbsp;P. Capilla","doi":"10.1016/j.redar.2025.501801","DOIUrl":"10.1016/j.redar.2025.501801","url":null,"abstract":"<div><div>Anterior cervical discectomy and fusion (ACDF) is a common surgical procedure with positive outcomes, but it is not without potentially serious complications for the patient.</div><div>We present the case of a patient who underwent ACDF and was found to have a cervical swelling prior to extubation. After a joint evaluation with the otolaryngology team, a suspicion of laryngeal structure dislocation was raised. A manual repositioning was performed prior to neuromuscular relaxation, and the patient was transferred intubated to the Recovery Unit due to a high risk of upper airway obstruction secondary to edema.</div><div>After 24<!--> <!-->hours of monitoring under scheduled corticosteroid treatment, a planned and safe extubation was carried out, witnessed by the otolaryngology team.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501801"},"PeriodicalIF":0.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134786","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}