Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Calentamiento bajo el cuerpo por manta de contacto de fibra de carbono frente a manta de aire forzado para prevenir la hipotermia durante la cirugía ginecológica laparoscópica: ensayo aleatorizado","authors":"M. Chanzá ,&nbsp;M. Núñez ,&nbsp;M.C. Velasco ,&nbsp;C. Rodríguez-Cosmen ,&nbsp;A.C. Carpintero ,&nbsp;L. Gallart","doi":"10.1016/j.redar.2024.501689","DOIUrl":"10.1016/j.redar.2024.501689","url":null,"abstract":"<div><h3>Background</h3><div>Studies comparing intraoperative warming devices report discordant or out-of-date results. This trial compared two underbody warming devices.</div></div><div><h3>Methods</h3><div>Thirty patients undergoing elective prolonged laparoscopic gynecologic surgery were randomized to underbody warming by forced air (n<!--> <!-->=<!--> <!-->15) or contact with a carbon fiber blanket (n<!--> <!-->=<!--> <!-->15). The main outcome was esophageal temperature at the end of surgery. We also compared temperature throughout surgery and need for rescue warming, blood loss, fluids infused, urine output, and adverse events. Outcomes were compared with χ² or Fisher exact tests, <em>t</em>-tests, and mixed effects models as appropriate.</div></div><div><h3>Results</h3><div>No median (interquartile range) differences between forced-air and contact warming were found in initial or final temperatures (36.2<!--> <!-->°C [36.0, 36.2] <em>vs</em> 36.3<!--> <!-->°C [35.9, 36.6] and 36.6<!--> <!-->°C [36.2, 36.8] <em>vs</em> 36.3<!--> <!-->°C [35.6, 36.5]). Temperature slightly increased over time in the forced-air group and slightly decreased in the contact group (0.11<!--> <!-->°C/h [0.02, 0.19] <em>vs</em> −0.05<!--> <!-->°C/h [−0.13, 0.03], <em>P</em> <!-->=<!--> <!-->.008). A single patient required rescue warming (in the contact group after 4.75<!--> <!-->h). Surgery took longer in the contact group (3.2<!--> <!-->h [2.5, 3.8] <em>vs</em> 4.0<!--> <!-->h [2.9, 5.6] h, <em>P</em> <!-->=<!--> <!-->.042). Two surgeons complained of dizziness related to ambient heat in the forced-air group. No differences were found in the remaining variables.</div></div><div><h3>Conclusions</h3><div>During use of the underbody forced-air and carbon-fiber warming devices tested, we recorded only very slight differences in temperature changes over the course of surgery. The variations can be considered clinically unimportant as no significant difference was evident at the end of surgery.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 5","pages":"Article 501689"},"PeriodicalIF":0.9,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882058","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":"Impacto del uso universal del videolaringoscopio McGrath como primera opción para todas las intubaciones en el quirófano: protocolo del estudio prospectivo, multicéntrico VIDEOLAR-SURGERY con metodología pre-post","authors":"M. Taboada ,&nbsp;A. Estany-Gestal ,&nbsp;P. Rama-Maceiras ,&nbsp;M.A. Orallo ,&nbsp;M. Bermúdez ,&nbsp;C. Barreiro ,&nbsp;L. Gómez ,&nbsp;M. Amor ,&nbsp;F. Otero ,&nbsp;J. Fernández ,&nbsp;N. Molins ,&nbsp;J.J. Amate ,&nbsp;B. Bascuas ,&nbsp;R. Rey ,&nbsp;M.C. Alonso ,&nbsp;M.J. Castro ,&nbsp;A. Sarmiento ,&nbsp;L. dos Santos ,&nbsp;C. Nieto ,&nbsp;S. Paredes ,&nbsp;E. Paz","doi":"10.1016/j.redar.2024.07.003","DOIUrl":"10.1016/j.redar.2024.07.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Usual tracheal intubation performed in the operating room is based on direct laryngoscopy, using a standard Macintosh laryngoscope. Several authors recommend the universal use of a videolaryngoscope as the first option for all intubations, regardless of whether the patient has predictors of a difficult airway or not. We hypothesize that using the McGrath videolaryngoscope as the first intubation option increases the frequency of patients with easy intubation, and decreases complications associated to the intubation.</div></div><div><h3>Methods and analysis</h3><div>The VIDEOLAR-SURGERY trial is a prospective, multicenter, open-label, interventional, before-after study. In the pre-implementation period (non-interventional phase, 6-9<!--> <!-->months [2600 intubations]), 35 anesthesiologists from 8<!--> <!-->hospitals perform all tracheal intubations for an elective or urgent surgical procedure using the standard Macintosh direct laryngoscope as the first intubation option. During the implementation period (2<!--> <!-->months), a McGrath Mac videolaryngoscope is provided to each anesthesiologist to train in its use. During the post-implementation period (interventional-phase, 6-9<!--> <!-->months [2600 intubations]), the 35 anesthesiologists perform all tracheal intubations using a McGrath Mac videolaryngoscope as the first intubation option. The main objective of present study is to evaluate whether the use of a McGrath Mac videolaryngoscope as the first intubation option, improves the percentage of patients with easy intubation compared with the standard Macintosh laryngoscope.</div></div><div><h3>Ethics and dissemination</h3><div>The study protocol was approved May 2, 2023, by the Ethics Committee of Galicia, Spain (CEI-SL, code No. 2023-177), and was registered into the Clinicaltrials.gov clinical trials registry with No. NCT NCT05850260. Informed consent is required. The results will be submitted for publication in a peer-reviewed journal and presented at one or more scientific conferences. If videolaryngoscope improves easy intubation compared with Macintosh direct laryngoscope when it is used for all intubations in operating room, its use may will become standard practice, thereby decreasing complications associated with the intubation procedure.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 1","pages":"Article 101649"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143127930","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":"Incidencia y factores de riesgo de dolor crónico en cirugía torácica: un estudio retrospectivo","authors":"H. Rivera-Ramos,&nbsp;L. Larrañaga-Altuna,&nbsp;M. García-Olivera,&nbsp;M. Armengol-Gay,&nbsp;M. Soldevilla-García,&nbsp;S. Bermejo-Martínez","doi":"10.1016/j.redar.2024.06.003","DOIUrl":"10.1016/j.redar.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Chronic post-thoracic surgery pain (CPTSP) is a common complication that affects a patient's quality of life. Thoracotomy is associated with a high risk of chronic pain. Video-assisted thoracoscopy surgery (VATS) is a less traumatic option, but its role in the development of CPTSP is unclear. Regardless of the approach, there is evidence that demographic, psychosocial, or clinical factors also contribute to pain. The primary objective of this study is to determine the incidence of CPTSP in our hospital. The secondary objective is to identify possible risk factors related to CPTSP.</div></div><div><h3>Method</h3><div>Retrospective, single-centre observational study. The medical records of patients that underwent thoracic surgery between January 2016 and January 2020 were reviewed. The diagnosis of CPTSP was made by reviewing the postoperative visits 6 months after surgery. We analysed the relationship between CPTSP and a series of variables, and then constructed a multivariate binary logistic regression model with a significance level of p<!--> <!-->&lt;<!--> <!-->0.05.</div></div><div><h3>Results</h3><div>A total of 259 patients were analyzed, 46.7% underwent VATS and 53.3% underwent thoracotomy. The overall incidence of CPTSP was 12%; 4.1% in VATS and 18.8% in thoracotomies. The multivariate model revealed that acute postoperative pain severe and a greater number of chest tubes were risk factors for CPTSP.</div></div><div><h3>Conclusion</h3><div>The incidence of CPTSP was 12% in our hospital. Patients with higher acute postoperative pain severe and several chest tubes were more likely to develop CPTSP.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 1","pages":"Article 101644"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143127933","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":"Ecoanatomía de la vía aérea difícil. Estudio de casos y controles","authors":"P. Kot ,&nbsp;L. Rovira ,&nbsp;M. Granell ,&nbsp;P. Rodriguez ,&nbsp;B. Cano ,&nbsp;S. Pozo ,&nbsp;J. De Andrés","doi":"10.1016/j.redar.2024.06.001","DOIUrl":"10.1016/j.redar.2024.06.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The occurrence of a difficult airway during intubation is a critical event in anaesthesia. Despite the usefulness of clinical predictors, difficult intubation frequently arises unexpectedly. The aim of this study was to determine the utility of airway ultrasound in detecting these patients.</div></div><div><h3>Materials and methods</h3><div>This was a case-control study. The patients in the case group were identified from the registry of patients with reports of difficult laryngoscopy (Cormack III and IV). The controls were selected from among patients classed as Cormack I who underwent surgery under general anaesthesia. Fifty patients (25 cases and 25 controls) participated in the study. All patients underwent ultrasound to obtain 3 measurements: distance from the skin to the hyoid bone, distance from the skin to the epiglottis, and distance from the skin to the vocal cords.</div></div><div><h3>Results</h3><div>A skin-to-hyoid bone distance greater than 9.8 mm (50% of the sample) generated an odds ratio of 5.46 (p<!--> <!-->=<!--> <!-->0.005); a skin-to-epiglottis distance greater than 21.3 mm (50% of the sample) generated an odds ratio of 6.62 (p<!--> <!-->=<!--> <!-->0.002). There was no significant difference in the skin-to-vocal cords distance.</div></div><div><h3>Conclusions</h3><div>Ultrasound has proven to be a useful tool for predicting difficult laryngoscopy. Despite the low sensitivity of clinical predictors, they appear to improve the detection of patients with difficult laryngoscopy when integrated into predictive models alongside ultrasound values.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 1","pages":"Article 101642"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143093346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nota de editor","authors":"","doi":"10.1016/j.redar.2024.501720","DOIUrl":"10.1016/j.redar.2024.501720","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 1","pages":"Article 501720"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143127866","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":"Análisis cuantitativo de la dispersión y la variabilidad del bloqueo del nervio geniculado: correlaciones anatómicas e implicaciones clínicas","authors":"T. Cuñat ,&nbsp;X. Sala-Blanch ,&nbsp;P. Pietrantoni ,&nbsp;J. Pomés ,&nbsp;S. Pregnolato ,&nbsp;A. Prats-Galino","doi":"10.1016/j.redar.2024.05.004","DOIUrl":"10.1016/j.redar.2024.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Despite advancements in anaesthesiology and regional anaesthesia, the three-dimensional spread of local anaesthetics is still poorly understood. This study investigates the pericapsular spread of radiopaque contrast after ultrasound-guided genicular nerve block in cadaveric knees using CT reconstruction. The aim is to assess the reproducibility, accuracy, and variability of this technique in order to improve safety and effectiveness.</div></div><div><h3>Methods</h3><div>We used a four-stage methodology that involved performing genicular nerve block on cadaveric knees, acquiring data using high-resolution ultrasound and helical CT imaging, performing segmentation and surface reconstruction of the CT images, and analysing the data quantitively to determine the spread of the infiltrate in each genicular nerve region. Coefficients of variation were calculated to estimate the spread and reproducibility of each genicular nerve block.</div></div><div><h3>Results</h3><div>Our results revealed significant variability in spread in all genicular nerve blocks, particularly around the recurrent genicular nerve. Despite this variability, the spread—particularly along the medial-lateral and anterior-posterior axes—showed moderate consistency. Furthermore, the regions covered by 80% of the spread closely matched the pericapsular distribution of the genicular nerves of the knee.</div></div><div><h3>Conclusions</h3><div>Notable variability in spread was observed in genicular nerve blocks, particularly around the recurrent genicular nerve. However, the spread showed moderate consistency and aligns closely with the pericapsular nerve distribution of the knee. Future studies should combine quantitative analysis with anatomical dissection to further investigate the involvement of the deep peroneal motor branch.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 1","pages":"Article 101640"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845058","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":"Recirculación sanguínea durante la terapia continua de depuración renal debido a un trombo en la vena cava inferior","authors":"J. Carballo Fernández,&nbsp;A. González Pereira,&nbsp;M.T. Rey Rilo,&nbsp;O. Pato López","doi":"10.1016/j.redar.2024.03.006","DOIUrl":"10.1016/j.redar.2024.03.006","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 1","pages":"Article 101626"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141031115","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 del paciente con fractura de cadera y tratamiento con fármacos anticoagulantes o antiagregantes. Recomendaciones de consenso de la sección de hemostasia de la SEDAR","authors":"C. Cassinello ,&nbsp;R. Ferrandis ,&nbsp;A. Gómez-Luque ,&nbsp;F. Hidalgo ,&nbsp;J.V. Llau ,&nbsp;G. Yanes-Vidal ,&nbsp;P. Sierra","doi":"10.1016/j.redar.2024.501651","DOIUrl":"10.1016/j.redar.2024.501651","url":null,"abstract":"<div><h3>Background</h3><div>Antiaggregant and anticoagulant therapy complicate the management of patients with osteoporotic hip fracture.</div></div><div><h3>Methods</h3><div>The haemostasis section of SEDAR established a working group to define an action plan for the management of antiaggregated or anticoagulated patients with an osteoporotic hip fracture. The suggested recommendations are based on evidence of best practices, and have been validated by a multidisciplinary group formed by 6 specialties.</div></div><div><h3>Results</h3><div>Early surgery reduces complications and mortality and improves patient comfort and functional recovery, with no difference in mortality between intradural and general anaesthesia.</div></div><div><h3>Conclusions</h3><div>Although uncertainties remain, it is recommended to perform surgery within 24-48<!--> <!-->hours of admission, adapting peripheral nerve blocks and type of anesthesia (neuraxial or general) an to the haemostatic conditions. A multimodal management of antithrombotics, and the optimisation of haemostasis, haemoglobin and venous thromboprophylaxis since admission are suggested.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 1","pages":"Article 501651"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143128022","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":"Perforación cardiaca y neumotórax izquierdo simultáneos como complicaciones de sonda de marcapasos transitorio","authors":"J.F. Muñoz Moreno,&nbsp;L. Segovia García de Marina,&nbsp;C.M. Marín Marín,&nbsp;L.J. Yuste Domínguez","doi":"10.1016/j.redar.2023.11.006","DOIUrl":"10.1016/j.redar.2023.11.006","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 1","pages":"Article 101596"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140467411","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":"Anestesia espinal continua para trasplante renal en una paciente de lupus con regurgitación mitral grave: informe de un caso","authors":"A.A. Pires ,&nbsp;M.J. Correia ,&nbsp;J. Sousa","doi":"10.1016/j.redar.2024.01.009","DOIUrl":"10.1016/j.redar.2024.01.009","url":null,"abstract":"<div><div>Anaesthesia for kidney transplant in a patient with severe mitral regurgitation is a real challenge given the need for judicious haemodynamic management to avoid pulmonary oedema and maximise reperfusion of the transplanted organ. This is the first experience described in the literature of continuous spinal anaesthesia in a patient with chronic severe mitral regurgitation undergoing cadaver donor kidney transplant. Transthoracic echocardiography monitoring was used during the procedure to avoid aggravating the patient's mitral regurgitation. Intraoperatively, 17.5<!--> <!-->ml/kg of crystalloids were administered and no vasopressors were required. Continuous spinal anaesthesia preserved haemodynamics and graft perfusion during the procedure.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 1","pages":"Article 101617"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047742","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}