Revista Espanola de Anestesiologia y Reanimacion最新文献_第7页

Factores de riesgo para PPC en cirugía abdominal laparoscópica no robótica frente a la laparoscópica robótica (LapRas): Razonamiento y protocolo mediante un análisis a nivel de paciente de LAS VEGAS y AVATaR 非机器人腹腔镜与机器人腹腔镜腹部手术（LapRas）中CLP的风险因素：利用 LAS VEGAS 和 AVATaR 进行的患者层面分析得出的理由和方案

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redar.2024.01.008

{"title":"Factores de riesgo para PPC en cirugía abdominal laparoscópica no robótica frente a la laparoscópica robótica (LapRas): Razonamiento y protocolo mediante un análisis a nivel de paciente de LAS VEGAS y AVATaR","authors":"","doi":"10.1016/j.redar.2024.01.008","DOIUrl":"10.1016/j.redar.2024.01.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative pulmonary complications (PPC) vary in different surgical techniques. We aim to compare the incidence of PPCs after laparoscopic non-robotic versus laparoscopic robotic abdominal surgery.</div></div><div><h3>Methods and analysis</h3><div>LapRas (Risk Factors for PPCs in Laparoscopic Non-Robotic vs Laparoscopic Robotic Abdominal Surgery) analyses harmonized data from two observational studies on abdominal surgery patients and PPCs: Local ASsessment of VEntilatory management during General Anaesthesia for Surgery (LAS VEGAS), and Assessment of Ventilation during general AnesThesia for Robotic surgery (AVATaR). The primary endpoint is the occurrence of one or more PPC within the first five postoperative days. Secondary endpoints include the occurrence of each individual PPC, hospital length of stay, and in-hospital mortality. Logistic regression models will be used to identify risk factors for PPCs in laparoscopic non-robotic versus laparoscopic robotic abdominal surgery. We will investigate whether differences in the occurrence of PPCs between the groups are driven by differences in duration of anaesthesia and/or the intensity of mechanical ventilation.</div></div><div><h3>Ethics and dissemination</h3><div>This analysis will address a clinically relevant research question by comparing laparoscopic and robotic surgery. No additional ethical committee approval is required for this meta-analysis. Data will be shared with the scientific community in the form of abstracts and original articles submitted to peer-reviewed journals.</div></div><div><h3>Registration</h3><div>The registration of this post-hoc analysis is pending; individual studies that were merged into the study database were registered at clinicaltrials.gov: LAS VEGAS with identifier <span><span>NCT01601223</span><svg><path></path></svg></span>, AVATaR with identifier <span><span>NCT02989415</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"71 8","pages":"Pages 592-600"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763806","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}

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Abordaje transcava para inserción de endoprótesis aórtica. Un nuevo reto anestésico 经腔途径植入主动脉内假体。新的麻醉挑战

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redar.2023.09.006

{"title":"Abordaje transcava para inserción de endoprótesis aórtica. Un nuevo reto anestésico","authors":"","doi":"10.1016/j.redar.2023.09.006","DOIUrl":"10.1016/j.redar.2023.09.006","url":null,"abstract":"<div><div>The treatment of acute aortic syndrome has been benefited in recent years from the huge progress in endovascular techniques, compared to classical surgical treatment, by open surgery. Nevertheless, for endovascular treatment to be successful, it is essential for the patient to present adequate vascular access. Those cases with unfavourable vascular anatomy make it necessary to consider open surgery with significant morbidity, or even to reject surgery. A new approach to the abdominal aorta has recently been described as an indication for these patients with impossibility of other vascular access and absolute or relative contraindication to the transthoracic approach.</div><div>The anesthetic management of the aortic syndrome is well known and, even though there are a variety of options, all of them have proven safety and efficacy. The implementation of new surgical approaches and new possible complications imply a challenge for the anesthesiologist which, for now, has little or none scientific evidence.</div><div>We present the first case of transcaval aortic endoprosthesis implantation in Spain, its anesthetic implications, and a review of the literature.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"71 8","pages":"Pages 623-626"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464787","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}

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Uso de cannabinoides en el dolor agudo posoperatorio 使用大麻素治疗急性术后疼痛

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redar.2023.11.004

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Fracaso de la extubación: obstrucción de la vía aérea superior por chicle. Informe de un caso 拔管失败：口香糖导致上气道阻塞。病例报告

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redar.2023.11.001

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Aneurisma del seno de Valsalva causante de cierre espontáneo de defecto del tabique ventricular congénito 瓦尔萨尔瓦窦动脉瘤导致先天性室间隔缺损自发闭合

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redar.2023.03.009

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Encuesta nacional sobre la monitorización perioperatoria de anticoagulantes orales directos: encuesta MonACOD 直接口服抗凝剂围手术期监测全国调查：MonACOD 调查

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redar.2024.02.002

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Eficacia del bloqueo retrolaminar ecoguiado frente al bloqueo paravertebral clásico en pacientes sometidos a hernioplastia inguinal unilateral: estudio controlado aleatorizado 在接受单侧腹股沟疝成形术的患者中，超声引导下椎后区阻滞与传统椎旁阻滞的疗效：随机对照研究。

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redar.2024.01.005

{"title":"Eficacia del bloqueo retrolaminar ecoguiado frente al bloqueo paravertebral clásico en pacientes sometidos a hernioplastia inguinal unilateral: estudio controlado aleatorizado","authors":"","doi":"10.1016/j.redar.2024.01.005","DOIUrl":"10.1016/j.redar.2024.01.005","url":null,"abstract":"<div><h3>Background</h3><div>In daily surgical practice, inguinal hernioplasty is a frequent procedure that is frequently accompanied by severe postoperative pain. Multiple regional blocks have been described for analgesia after such operations. Retrolaminar block (RLB) is a paravertebral block (PVB) variant that provides excellent analgesia and reduces the risk of complications. This prospective trial compared the analgesic efficacy of PVB and RLB in the inguinal hernioplasty.</div></div><div><h3>Methods</h3><div>The 56 patients included were randomly assigned into two equal groups according to the block performed under ultrasound guidance at the T12 level: PVB group (28 patients) and RLB (28 patients). Time until the first rescue analgesia was our primary outcome. Other outcomes included the time to perform the block, changes in intraoperative hemodynamic parameters, postoperative VAS, 24-hour morphine consumption, the level of patient satisfaction, and the incidence of block-related complications.</div></div><div><h3>Results</h3><div>Demographic data were comparable in the two groups. However, the time needed for the block was significantly shortened with the RLB (p<0.001). Patients in the PVB groups expressed better pain scores and lower opioid consumption. Additionally, the time to the first call for opioid analgesia showed a significant prolongation in association with the PVB. There was no discernible difference in the frequency of adverse events and recorded MAP and HR.</div></div><div><h3>Conclusion</h3><div>The PVB has a superior perioperative analgesic profile compared to the RLB, which manifested in the prolonged duration to the first rescue analgesics, better pain scores, and less opioid consumption, with no significant increase in block-related complications.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"71 8","pages":"Pages 584-591"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269443","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}

引用次数: 0

La prolongación del intervalo QT en los pacientes con COVID-19 severa es multicausal y no se limita a los fármacos anti-SARS-CoV-2 严重 COVID-19 患者的 QT 延长有多种原因，并不局限于抗 SARS-CoV-2 药物。

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redar.2023.11.011

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Ácido úrico y daño renal agudo en pacientes con alto riesgo de desarrollar daño renal agudo sometidos a cirugía cardiaca: cohorte prospectiva multicéntrica 接受心脏手术的急性肾损伤高危患者的尿酸和急性肾损伤：前瞻性多中心队列。

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2023.09.005

{"title":"Ácido úrico y daño renal agudo en pacientes con alto riesgo de desarrollar daño renal agudo sometidos a cirugía cardiaca: cohorte prospectiva multicéntrica","authors":"","doi":"10.1016/j.redar.2023.09.005","DOIUrl":"10.1016/j.redar.2023.09.005","url":null,"abstract":"<div><h3>Purpose</h3><p>It is unclear whether preoperative serum uric acid (SUA) elevation may play a role in the development of acute kidney injury (AKI) associated with cardiac surgery (CSA-AKI). We conducted a cohort study to evaluate the influence of preoperative hyperuricemia on AKI in patients at high risk for developing SC-AKI.</p></div><div><h3>Design</h3><p>Multicenter prospective international cohort study.</p></div><div><h3>Setting</h3><p>Fourteen university hospitals in Spain and the United Kingdom.</p></div><div><h3>Participants</h3><p>We studied 261 consecutive patients at high risk of developing CSA-AKI, according to a Cleveland score ≥4 points, from July to December 2017.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Measurements and Main Results</h3><p>AKIN criteria were used for the definition of AKI. Multivariable logistic regression models and propensity score-matched pairwise analysis were used to determine the adjusted association between preoperative hyperuricemia (> = 7 mg/dL) and AKI. Elevated preoperative AUS (> = 7 mg/dL) was present in 190 patients (72.8%), whereas CSA-AKI occurred in 145 patients (55.5%). In multivariable logistic regression models, hyperuricemia was not associated with a significantly increased risk of AKI (adjusted Odds Ratio [OR]: 1.58; 95% confidence interval [CI]: 0.81-3; p = 0.17). In propensity score-matched analysis of 140 patients, the hyperuricemia group experienced similar adjusted odds of AKI (OR 1.05, 95% CI 0.93-1.19, p = 0.37).</p></div><div><h3>Conclusions</h3><p>Hyperuricemia was not associated with an increased risk of AKI in this cohort of patients undergoing cardiac surgery at high risk of developing CSA-AKI.</p></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"71 7","pages":"Pages 514-521"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S003493562400015X/pdfft?md5=166e065b850d42f573a927e270fa6e1b&pid=1-s2.0-S003493562400015X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140462380","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}

引用次数: 0

Hiperlactacidemia en pacientes con estatus asmático. Análisis mediante el modelo de Stewart 哮喘状态患者的高乳酸血症。使用斯图尔特模型进行分析

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2023.10.004

{"title":"Hiperlactacidemia en pacientes con estatus asmático. Análisis mediante el modelo de Stewart","authors":"","doi":"10.1016/j.redar.2023.10.004","DOIUrl":"10.1016/j.redar.2023.10.004","url":null,"abstract":"<div><h3>Background</h3><p>Patients with status asthmaticus (SA) frequently present with lactic acidosis (LA). Our goal is to identify the nature of LA using the Stewart physicochemical model and to identify the independent factors associated with LA in children with SA.</p></div><div><h3>Methods</h3><p>Analytical study of a retrospective cohort using a nested case-control design. Twenty-eight episodes of SA in 24 children were included. Patients admitted to a paediatric intensive care unit (PICU) for SA over a 9-year period were recruited consecutively. LA was analysed using the Stewart model and the Strong Ion Calculator. Data and were analysed using descriptive statistics and regression models were fitted in the general linear model.</p></div><div><h3>Results</h3><p>Hyperlacticaemia (Lact[mM/L]=3.905 [95% <span>C</span>I=3.018-4.792]) and acidosis (pH=7.294 [95% CI=7.241-7.339]) were observed in 18 episodes (15 patients; 62.5%). According to the Stewart model, acidosis was caused by a decrease in strong ion difference. Initially, pCO2 was high (pCO2[mmHg]=45.806 [95% CI=37.314-54.298]) but the net unmeasured ion (NUI) component was normal (NUI=-4,461 [95% CI=-3.51 - -5.412]), and neither changed significantly over the clinical course. There was no need to determine pyruvate, as the NUI was normal and the LA was type B (non-hypoxic, lactate / pyruvate <25). We observed a correlation (p=0.023) between LA and intramuscular epinephrine administered on arrival at hospital, but not between LA and the cumulative dose of nebulized salbutamol.</p></div><div><h3>Conclusions</h3><p>Most patients with SA presented LA. The Stewart model confirmed that LA is not hypoxic, probably due to sympathomimetic-related glycolysis.</p></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"71 7","pages":"Pages 501-505"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278824","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}

引用次数: 0