Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Redefiniendo la analgesia perioperatoria: impacto de la anestesia libre de opioides en cirugía de mama","authors":"Ó. Roca-Viéitez,&nbsp;J. Iglesias-López de Prado,&nbsp;P. Casas-Reza,&nbsp;M. Gestal-Vázquez,&nbsp;O. Sobrino-Robelo,&nbsp;P. Subirán-Rodríguez","doi":"10.1016/j.redar.2026.502048","DOIUrl":"10.1016/j.redar.2026.502048","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Opioid-free anesthesia (OFA) aims to achieve effective perioperative pain control while avoiding the adverse effects associated with opioid use. Its usefulness in breast surgery remains poorly studied. The primary objective of this study was to compare morphine consumption in the post-anesthesia care unit (PACU) between patients undergoing OFA and those receiving conventional opioid-based anesthesia.</div></div><div><h3>Material and methods</h3><div>A retrospective, observational, single-center study was conducted at the University Hospital of A Coruña. A total of 87 patients who underwent breast surgery between January and July 2022 were included. Two groups were compared: OFA (n<!--> <!-->=<!--> <!-->41) and conventional opioid-based anesthesia (non-OFA, n<!--> <!-->=<!--> <!-->46). The need for morphine rescue at PACU discharge, at 24<!--> <!-->h, and at 48<!--> <!-->h postoperatively (if patients remained hospitalized) was recorded. Secondary outcomes included the incidence of postoperative nausea and vomiting, oral tolerance, night rest, and length of stay in the PACU and hospital.</div></div><div><h3>Results</h3><div>The OFA group showed significantly lower morphine consumption in the recovery unit (9.8 vs. 47.8%; p<!--> <!-->&lt;<!--> <!-->0.001), with an absolute risk reduction of 38.1%. No postoperative nausea and vomiting events were observed in the OFA group compared with 21.7% in the non-OFA group (p<!--> <!-->=<!--> <!-->0.001). Delayed oral tolerance was more frequent in the non-OFA group (0 vs. 15.2%; p<!--> <!-->=<!--> <!-->0.013), and night rest was also better in the OFA group (94.4 vs. 65.7%; p<!--> <!-->&lt;<!--> <!-->0.05). No differences were found in PACU or hospital length of stay.</div></div><div><h3>Discussion</h3><div>The OFA technique provided adequate analgesic control with a significant reduction in postoperative adverse effects.</div></div><div><h3>Conclusions</h3><div>OFA in breast surgery is a safe and effective technique that improves postoperative recovery.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502048"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652980","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":"Enfermedad de Forestier: la radiografía que anticipa la vía aérea difícil","authors":"M. Arias Salazar,&nbsp;R. Bergé,&nbsp;A. Cayuso,&nbsp;M. Sangrà-Puig","doi":"10.1016/j.redar.2025.502022","DOIUrl":"10.1016/j.redar.2025.502022","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502022"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652970","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 interescalénico frente a bloqueo del tronco superior en artroscopia de hombro: estudio comparativo aleatorizado de la facilidad de las dos técnicas entre los residentes","authors":"A.M.M. Ahmed,&nbsp;M.A. Moustafa,&nbsp;A.S. Alabd","doi":"10.1016/j.redar.2026.502092","DOIUrl":"10.1016/j.redar.2026.502092","url":null,"abstract":"<div><h3>Introduction</h3><div>Interscalene brachial plexus block (ISB) remains the gold standard nerve block in shoulder arthroscopic surgery. However, some anatomical variations exist in addition to several reported complications and technical challenges. Upper trunk block (UTB) may be a feasible alternative. The primary outcome was the success rate of UTB and ISB. Secondary outcomes included: duration of block performance, guidance interventions, visualization of anatomic structures, postoperative pain and opioid consumption, and diaphragmatic function.</div></div><div><h3>Methods</h3><div>One hundred and twenty patients were divided randomly into 2 groups; 60 patients received ISB before general anaesthesia (GA) and 60 patients received UTB before GA. All blocks were performed by anaesthesia trainees under supervision of an attending consultant.</div></div><div><h3>Results</h3><div>Age, sex, BMI, and duration of surgery were not different statistically. The duration of block performance was significantly longer in the ISB group (p<!--> <!-->=<!--> <!-->0.002). Guidance interventions in the ISB group were higher than the UTB group (p<!--> <!-->&lt;<!--> <!-->0.001). There were no significant differences regarding the worst postoperative pain score (p<!--> <!-->=<!--> <!-->0.574), postoperative nalbuphine consumption (p<!--> <!-->=<!--> <!-->0.813) or success rate (p<!--> <!-->=<!--> <!-->0.31) between groups. Visualization of the anatomic structures in the 2 groups was not statistically significant (p<!--> <!-->=<!--> <!-->0.183). Diaphragmatic function was significantly affected in the ISB group (45% complete paralysis and 35% paresis) versus (8.3% complete paralysis and 30% paresis) in the UTB group.</div></div><div><h3>Conclusions</h3><div>UTB may be considered a safer and a technically easier approach than ISB for providing equivalent intra and postoperative regional analgesia in arthroscopic shoulder surgery by anaesthesia trainees.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502092"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652979","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":"Efectos de los bloqueos caudales vs. perianales guiados por ecografía en el tono intraoperatorio del esfínter anal y la analgesia posoperatoria durante los procedimientos con preservación del esfínter: un ensayo comparativo aleatorizado","authors":"A.M. Adel AbdelMoneim,&nbsp;M. Bassem Helmy,&nbsp;M. Adolf Helmy,&nbsp;O. Mohamed Asaad,&nbsp;A. Hassan Saleh,&nbsp;M. Hamed El-Sherbiny","doi":"10.1016/j.redar.2026.502091","DOIUrl":"10.1016/j.redar.2026.502091","url":null,"abstract":"<div><h3>Background</h3><div>Data comparing the effects of caudal epidural anesthesia and perianal block during anal sphincter sparing procedures under general anesthesia are limited. We aimed to compare the efficacy and safety of ultrasound-guided caudal block versus perianal block on anal sphincter muscle tone and in reducing postoperative pain among patients undergoing anal sphincter-sparing procedures.</div></div><div><h3>Methods</h3><div>This randomized double-blinded study enrolled 46 adult patients, American Society of Anesthesiologists physical status I or II, who underwent anal sphincter sparing procedures under general anesthesia. Patients were randomly assigned to one of two groups (23 patients each). Group A received an ultrasound-guided caudal block, while Group B received a perianal block. The primary outcome was duration of postoperative analgesia. Secondary outcomes included total postoperative morphine consumption, postoperative pain intensity, time to postoperative ambulation, intraoperative external anal sphincter muscle tone by Digital rectal scoring system (DRESS), satisfacción del paciente, and incidence of complications.</div></div><div><h3>Results</h3><div>Patients in group A had a statistically significant longer time to first analgesic request and lower morphine consumption than those in group B (2.50<!--> <!-->±<!--> <!-->0.27 vs. 1.57<!--> <!-->±<!--> <!-->0.53<!--> <!-->hours, and 3.30<!--> <!-->±<!--> <!-->2.18<!--> <!-->mg vs. 5.87<!--> <!-->±<!--> <!-->2.05<!--> <!-->mg, p &lt;<!--> <!-->0.001). Although these differences are modest in magnitude, they may contribute to improved recovery when combined with multimodal analgesia strategies. Moreover, caudal block resulted in shorter ambulation time (2.17<!--> <!-->±<!--> <!-->0.38 vs. 3.48<!--> <!-->±<!--> <!-->0.53<!--> <!-->hours), and numeric rating scale (1.96<!--> <!-->±<!--> <!-->0.56 vs. 3.48<!--> <!-->±<!--> <!-->0.66, p &lt;<!--> <!-->0.001). The DRESS and Likert scores were significantly higher in patients in group A than in group B (2.83<!--> <!-->±<!--> <!-->0.38 vs. 2.22<!--> <!-->±<!--> <!-->0.42, and 3.78<!--> <!-->±<!--> <!-->0.42 vs. 2.48<!--> <!-->±<!--> <!-->0.66, p &lt;<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>In anal sphincter-sparing operations, ultrasound-guided caudal epidural blocks combined with general anesthesia may improve pain management, reduce opioid requirements, and thereby lower the incidence of postoperative nausea and vomiting, while maintaining anal sphincter tone compared to local perianal block.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502091"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652987","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":"Creación y validación de una métrica de competencia y error de la técnica de intubación orotraqueal con videolaringoscopio de pala angulada (GlideScope®)","authors":"M. Coll-Badell ,&nbsp;J.V. Serrano-Gonzalvo ,&nbsp;L. Carrillo-Luna ,&nbsp;J.M. Soto-Ejarque ,&nbsp;C. Ramírez-Miranda ,&nbsp;C. Añez-Simón","doi":"10.1016/j.redar.2026.502071","DOIUrl":"10.1016/j.redar.2026.502071","url":null,"abstract":"<div><h3>Objectives</h3><div>The main objective of this study was to create and validate a metric for the correct performance of orotracheal intubation with an angled blade video laryngoscope (GlideScope®). The secondary objectives were to break down the technique into correct phases and steps (competency metrics), define errors and critical errors.</div></div><div><h3>Method</h3><div>Prospective observational study divided into two phases. In phase<!--> <!-->I, the metric was created: a group of experts deconstructed the procedure, identifying phases and defining the competence metrics and errors with the help of three previous recordings. The metrics were stress-tested for objectivity and consensus was sought in a meeting of 24 experts using the modified Delphi methodology. In phase<!--> <!-->II, the metric was validated by recording 9 experienced and 9 novice professionals performing the procedure on a mannequin. Subsequently, 2 external evaluators, previously trained in the use of the metric, evaluated the videos independently.</div></div><div><h3>Results</h3><div>A metric was created, defined by 4 phases, 22 competency metrics, and 31 errors, of which 16 were considered critical. Experienced professionals completed more competency metrics than novices: 17.05 vs. 13.72 (<em>P</em> <!-->=<!--> <!-->.010), had fewer total errors (<em>P</em> <!-->=<!--> <!-->.0017) and fewer critical errors: 0.55 vs. 2.61 (<em>P</em> <!-->&lt;<!--> <!-->0.001). Inter-rater agreement for the total score of all videos was &gt;<!--> <!-->0.80.</div></div><div><h3>Conclusions</h3><div>The metric created is valid and reliably discriminates between operators who are competent and those who are not competent in performing the technique.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502071"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652981","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":"Desafíos y oportunidades para una analgesia personalizada","authors":"S. López Álvarez","doi":"10.1016/j.redar.2025.502031","DOIUrl":"10.1016/j.redar.2025.502031","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502031"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652983","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":"Nitazenos: desafíos emergentes en la atención urgente por opioides sintéticos","authors":"A. Alcántara Montero","doi":"10.1016/j.redar.2025.502000","DOIUrl":"10.1016/j.redar.2025.502000","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 4","pages":"Article 502000"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147652985","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":"Síndrome de respuesta inflamatoria sistémica tras circulación extracorpórea: prevalencia, predictores y resultados","authors":"J.J. Nuño-Pulido ,&nbsp;R. Gopar-Nieto ,&nbsp;G. Rojas-Velasco ,&nbsp;D. Manzur-Sandoval","doi":"10.1016/j.redar.2025.502021","DOIUrl":"10.1016/j.redar.2025.502021","url":null,"abstract":"<div><h3>Background</h3><div>Systemic inflammatory response syndrome (SIRS) is a frequent and critical complication following cardiac surgery, particularly in patients undergoing cardiopulmonary bypass (CPB). Although SIRS is associated with increased morbidity and mortality, its impact on hemodynamic stability and postoperative outcomes remains unclear. This study aimed to determine the prevalence of SIRS in patients undergoing cardiac surgery with CPB at the Instituto Nacional de Cardiología Ignacio Chávez and to explore its association with preoperative comorbidities, intraoperative factors, hemodynamic alterations, vasoactive drug requirements, and adverse outcomes.</div></div><div><h3>Methods</h3><div>A retrospective, observational study was conducted on 546 adult patients who underwent cardiac surgery with CPB. Patients were classified into SIRS and non-SIRS groups based on standard clinical criteria. Statistical analysis included normality testing (Shapiro-Wilk), comparisons of continuous and categorical variables (Mann-Whitney U test, χ², and Fisher's exact test), and logistic regression to identify predictors of outcomes.</div></div><div><h3>Results</h3><div>SIRS was present in 31.86% of patients upon ICU admission. The most frequent criterion was leukocytosis (69.05%), followed by tachycardia (33.88%). Patients with SIRS exhibited elevated inflammatory markers and increased requirements for vasoactive drugs. SIRS significantly increased the odds of several postoperative complications: mediastinal bleeding (OR 2.08, 95%CI: 1.24-3.48), vasoplegic syndrome (OR 1.79, 95%CI: 0.92-3.49), low cardiac output syndrome (OR 1.71, 95%CI: 1.02-2.85), acute kidney injury (OR 1.69, 95%CI: 1.15-2.48), and in-hospital mortality (OR 1.83, 95%CI: 0.90-3.72).</div></div><div><h3>Conclusion</h3><div>SIRS is a prevalent and clinically significant condition in postoperative cardiac surgery patients. The SIRS score serves as a valuable tool for risk stratification. Early identification and targeted interventions may improve patient outcomes. Further prospective studies are needed to refine predictive models and optimize management strategies.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 502021"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427245","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":"Eficacia del uso intratecal de antagonistas del receptor para prevenir el prurito y los NVPO tras la anestesia espinal. Revisión sistemática y metaanálisis","authors":"A.U. Huda ,&nbsp;R. Fernando ,&nbsp;H.B. Ghafoor ,&nbsp;R. Minhas","doi":"10.1016/j.redar.2025.502034","DOIUrl":"10.1016/j.redar.2025.502034","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and objective&lt;/h3&gt;&lt;div&gt;Different adjuvants are used in combination with intrathecal local anesthesia to improve the quality of spinal anesthesia. Opioids are most used for this purpose, but these are associated with side effects such as pruritus and postoperative nausea and vomiting. Various medications have been utilized for prophylaxis or treatment of these side effects especially pruritus. Although mu-receptor antagonists are generally used intravenously or subcutaneously for the treatment of pruritus, few studies have investigated the role of intrathecal mu-receptor antagonists. So, this systematic review aimed to evaluate the effect of using intrathecal mu-receptor antagonists when used with local anesthetics like bupivacaine, and opioids for the prevention of opioid-related side effects.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;This meta-analysis was conducted while following PRISMA guidelines. We registered this review with the PROSPERO database in February 2025. Two authors performed the literature searches in February 2025 and then repeated after one month to ensure accuracy. Two authors independently appraised the individual studies according to the Consolidated Standards of Reporting Trials checklist. Literature search was done using online databases including PubMed, Google Scholar, Science Direct and Cochrane library. Potential bias was evaluated using the risk of bias-2 (RoB-2) tool. We included randomized controlled trials that compared intrathecal mu-receptor antagonists with control for patients undergoing surgery under spinal anesthesia. The primary outcome of the study was the incidence of pruritus. We utilized the Review manager software, RevMan for MAC 5.4, to conduct the meta-analysis. Mean difference (MD), standard mean difference (SMD) and odds ratio (OR) were calculated for different outcomes. Using random effect models, Peto OR were used for weighing models. Funnel plots and Egger's test were utilized to assess the risks for publication bias across studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 9 randomised controlled trials (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;653) were included in this systematic review and meta-analysis. The incidence of pruritus in mu-receptor antagonist group was 19.3 vs 58.8 in the control group with an OR of 0.15 (&lt;em&gt;P&lt;/em&gt;&lt;.00001 [CI: 0.11-0.21]). Mu-receptor antagonists significantly reduced the incidence of PONV with an OR of 0.26 (&lt;em&gt;P&lt;/em&gt;&lt;.00001 [CI: 0.18-0.36]). &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; value for pruritus was 32% while it was 72% for PONV. There was no significant difference in VAS pain scores between two groups during the first 24&lt;!--&gt; &lt;!--&gt;hours except at 2&lt;!--&gt; &lt;!--&gt;hours postoperatively. Furthermore, the use of intrathecal mu-receptor antagonists did not significantly affect the time to first analgesic request.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The use of intrathecal mu-receptor antagonists significantly reduces the occurrence of opioid-related ","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 502034"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427248","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 de Práctica Clínica sobre el acompañamiento parental en quirófano durante la inducción anestésica en Pediatría","authors":"M. López Segura ,&nbsp;P. Sanabria Carretero ,&nbsp;D. Gil Mayo ,&nbsp;D. Fabián González ,&nbsp;C. Solé Bertran ,&nbsp;A.J. Winter ,&nbsp;F.J. Escribá Alepuz ,&nbsp;J. García Fernández","doi":"10.1016/j.redar.2025.502028","DOIUrl":"10.1016/j.redar.2025.502028","url":null,"abstract":"<div><h3>Introduction</h3><div>Parental accompaniment during anesthesia induction in pediatric patients has become a key strategy in the humanization of surgical care. Various studies have demonstrated its benefits in reducing anxiety in both the pediatric patient and their parents, promoting cooperation and enhancing the perioperative experience. Consequently, there is a need for a clinical practice guideline to guide anesthesiology professionals in the safe and consistent application of this intervention.</div></div><div><h3>Objective</h3><div>To develop a clinical practice guideline that establishes evidence-based recommendations, based on expert consensus, for implementing parental accompaniment during anesthesia induction in the pediatric operating room.</div></div><div><h3>Methods</h3><div>The Humanization Working Group of the Pediatric Section of the Spanish Society of Anesthesia and Resuscitation (SEDAR) conducted a systematic review of national and international scientific literature, complemented by a multidisciplinary consensus process using the GRADE methodology and the Delphi technique.</div></div><div><h3>Results</h3><div>The guideline defines inclusion and exclusion criteria for patients and companions, proposes a structured action protocol, details safety measures, staff training, and communication strategies with families. Additionally, it offers specific recommendations for different hospital contexts and clinical situations.</div></div><div><h3>Conclusions</h3><div>This guideline serves as a practical tool to facilitate the implementation of parental accompaniment in pediatric operating rooms, in line with policies of humanization and quality of care. Its adoption will help improve the pediatric perioperative experience and strengthen the trust relationship between healthcare professionals and families.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 502028"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427250","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}