Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Valor predictivo de la pérdida de tono muscular y el índice de perfusión para el éxito del bloqueo del plexo braquial supraclavicular: estudio piloto","authors":"M.A. Hernández-Govea ,&nbsp;G.F. Álvarez-Orenday ,&nbsp;M. Guerra-Hernández ,&nbsp;V.B. Kway ,&nbsp;A.M. Castro-Alemán","doi":"10.1016/j.redar.2025.501986","DOIUrl":"10.1016/j.redar.2025.501986","url":null,"abstract":"<div><h3>Background</h3><div>Currently, no standardized tool accurately predicts the success of supraclavicular brachial plexus block (SBPB) in the shortest time possible. This study aimed to evaluate the early predictive value of muscle tone loss and perfusion index in predicting SBPB success. This is the first study to report the use of this device for objective assessment of nerve block success.</div></div><div><h3>Methods</h3><div>A prospective observational pilot study was conducted at”Dr. Ignacio Morones Prieto” Central Hospital, Mexico, involving 33 patients (ASA 1, 2, 3) requiring surgery on the distal third of the upper limb with ultrasound-guided SBPB. Exclusion criteria included infections at the puncture site, local anesthetic allergies, coagulopathies, restrictive pulmonary pathologies, oxygen dependency, brachial plexus radiculopathy, and uncontrolled diabetes. The motor block was assessed with a conductive ink flexion sensor (FS), and the sympathetic block was evaluated with perfusion index via pulse oximeter at 3, 5, 10, and 15<!--> <!-->minutes. Block success was defined as a Numerical Rating Scale (NRS) for pain &lt;<!--> <!-->2 during surgical stimulation. Statistical comparisons were made between successful and unsuccessful blocks, with ROC curve analysis identifying optimal cutoff points for predictive variables.</div></div><div><h3>Results</h3><div>Of the 33 patients, 24 had a successful block, and 9 did not. At 5<!--> <!-->minutes, a PI<!--> <!-->&gt;196.07 showed 100% sensitivity, 87.5% specificity, and AUC 92% (p &lt;<!--> <!-->0.001). A 27.38% loss in muscle strength showed 100% sensitivity, 87.5% specificity, and AUC 95% (p &lt;<!--> <!-->0.001). Combined, these parameters had a 100% predictive value (p &lt;<!--> <!-->0.005).</div></div><div><h3>Conclusion</h3><div>PI and muscle strength loss are reliable early predictors of SBPB success, offering a valuable tool for optimizing anesthetic strategies.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501986"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915377","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":"De la atonía uterina al SHUa: un caso de microangiopatía trombótica posparto","authors":"J.M. Blanco Flores,&nbsp;A.M. Oubiña López,&nbsp;A. San Antonio Gil,&nbsp;M. Reina Molina,&nbsp;P. Ramos Curado,&nbsp;M. Echevarría Moreno","doi":"10.1016/j.redar.2025.501983","DOIUrl":"10.1016/j.redar.2025.501983","url":null,"abstract":"<div><div>We report the case of a 42-year-old primiparous woman who developed severe postpartum hemorrhage due to uterine atony after an instrumental delivery, requiring massive transfusion and Bakri balloon placement. Despite initial hemodynamic stabilization, she progressed to persistent anuria and acute kidney injury. Imaging revealed bilateral renal cortical necrosis. In the presence of anemia, thrombocytopenia, complement consumption, and ADAMTS13 activity &gt;10%, atypical hemolytic uremic syndrome (aHUS) was suspected. Treatment with eculizumab and renal replacement therapy was initiated, achieving good hematologic response.</div><div>This case highlights a rare postpartum complication in which early suspicion enables prompt targeted therapy. Anesthesiologists play a key role in initial hemodynamic management and in identifying warning signs suggestive of thrombotic microangiopathies.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501983"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915375","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":"Implante ecoguiado de un neuroestimulador periférico en el canal de torsión radial. A propósito de un caso","authors":"J. Mateos-Granados ,&nbsp;L.E. Fernández-Rodríguez ,&nbsp;M.M. Hernández-García ,&nbsp;F. Martínez-Martínez ,&nbsp;V. Roqués-Escolar","doi":"10.1016/j.redar.2025.501982","DOIUrl":"10.1016/j.redar.2025.501982","url":null,"abstract":"<div><div>Peripheral neurostimulators may be used for treatment of neuropathic pain, and their use has increased with the use of ultrasound for its placement. Superficial radial nerve neuropathy is common, and distal humeral implants have been described with adequate pain relief, but not all patients present a positive test block in this site, which is needed for the implant. We present a case of ultrasound-guided implant of a peripheral neurostimulator in the radial spiral groove as treatment of superficial radial nerve neuropathy with adequate pain relief, although after one year the electrode suffered a fracture and had to be removed and reimplanted surgically. This new technique may be an effective alternative in selected patients, but further studies are needed.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501982"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915374","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":"Efecto de la anestesia libre de opioides en el dolor postoperatorio en cirugía ortopédica: revisión sistemática y metaanálisis de ensayos controlados aleatorizados","authors":"A. Bachtiar Effendi ,&nbsp;F. Cahya Ramadhan ,&nbsp;G.D. Ica Manohara ,&nbsp;R.M. Laksono","doi":"10.1016/j.redar.2025.501989","DOIUrl":"10.1016/j.redar.2025.501989","url":null,"abstract":"<div><h3>Background</h3><div>Opioid-free anaesthesia (OFA) is increasingly recognized as a perioperative approach that may offer effective pain control with reduced risk of adverse effects. Considering that orthopaedic surgeries often lead to at least moderate postoperative pain, we assessed the effectiveness and safety of OFA in orthopaedic procedures.</div></div><div><h3>Methods</h3><div>We searched PubMed, ScienceDirect, ProQuest, and EuropePMC for relevant randomised controlled trials (RCT) and supplemented the data with citation tracking. Data were analysed using RevMan version 5.4. The risk of bias and the certainty of evidence were evaluated using the Cochrane Risk of Bias 2.0 tool and the GRADE approach. The study was registered on PROSPERO (CRD420251048348).</div></div><div><h3>Results</h3><div>Seven RCTs involving 408 patients were included. The intensity of postoperative pain measured in the post-anaesthesia care unit (mean difference [MD]: −0.08), at 24<!--> <!-->hours (MD: −0.06), and at 48<!--> <!-->hours (MD: −0.26) was not statistically significant. OFA reduced the risk of postoperative nausea and vomiting (PONV) (RR: 0.37; <em>P</em> <!-->=<!--> <!-->.00001) and prolonged the time to first request for analgesia (MD: 25.60<!--> <!-->minutes; <em>P</em> <!-->=<!--> <!-->.00001). Twenty-four-hour morphine consumption was comparable across groups (MD: −0.28; <em>P</em> <!-->=<!--> <!-->.76). OFA reduced the incidence of intraoperative hypotension (risk ratio [RR]: 0.56; <em>P</em> <!-->=<!--> <!-->.02) but increased the risk of intraoperative bradycardia (RR: 1.86; <em>P</em> <!-->=<!--> <!-->.04).</div></div><div><h3>Conclusions</h3><div>In orthopaedic surgery, OFA provides comparable pain control to opioid-based anaesthesia. It also reduced the incidence of postoperative nausea and vomiting and intraoperative hypotension, and prolonged the time to the first request for analgesia (statistically, but not clinically). However, the potential risk of bradycardia should be considered when using dexmedetomidine-based analgesics.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501989"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915378","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":"Análogos del receptor GLP1 y consideraciones en el manejo perioperatorio: una revisión narrativa","authors":"A. Vázquez Lima,&nbsp;M. Vidal Lopo","doi":"10.1016/j.redar.2025.501985","DOIUrl":"10.1016/j.redar.2025.501985","url":null,"abstract":"<div><div>Glucagon-like peptide type 1 analogues (aGLP1) are a group of drugs capable of stimulating the GLP1 receptor, a key peptide in glycaemic homeostasis through its actions at the pancreatic and gastric level.</div><div>This narrative review summarises the possible implications of the perioperative use of this group of drugs. The pancreatic and extrapancreatic effects of aGLP1s determine their anaesthetic implications and perioperative management. The repercussions of their long-term suspension and their effects on the immune system have not yet been sufficiently clarified. The perioperative use of GLP1 agonists is associated with better glycaemic control without a significant increase in complications. However, their use involves a delay in gastric emptying dependent on multiple factors, which may increase the risk of bronchoaspiration.</div><div>At present, we can conclude that the perioperative maintenance of GLP1 agonists optimises glycaemic control and avoids disruptions to the potential benefits of treatment without demonstrating an increase in postoperative complications. Delayed gastric emptying and possible bronchoaspiration require measures to minimise risk and ensure patient safety.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501985"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915531","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 la Carta al Editor sobre «Dolor neuropático y crónico de nueva aparición en supervivientes de COVID-19 grave: análisis secundario del ensayo PAIN-COVID»","authors":"A. Ojeda,&nbsp;T. Cuñat,&nbsp;O. Comino-Trinidad,&nbsp;J. Aliaga,&nbsp;M. Arias,&nbsp;A. Calvo","doi":"10.1016/j.redar.2025.501997","DOIUrl":"10.1016/j.redar.2025.501997","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501997"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915361","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":"Análogos GLP-1: el nuevo reto silencioso en la seguridad de la vía aérea","authors":"M.A. Fernández-Vaquero ,&nbsp;C.A. Puga-Carrasco ,&nbsp;J.A. Sastre","doi":"10.1016/j.redar.2025.501991","DOIUrl":"10.1016/j.redar.2025.501991","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501991"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915376","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":"Experiencia con la ecografía gástrica prequirúrgica como herramienta para determinar el estómago lleno en pacientes adultos sometidos a cirugía de urgencia","authors":"J.C. Villalba ,&nbsp;J.M. Quintero ,&nbsp;C.E. Melo ,&nbsp;D.F. Reyes ,&nbsp;J.P. Tovar ,&nbsp;A. Perlas","doi":"10.1016/j.redar.2025.501994","DOIUrl":"10.1016/j.redar.2025.501994","url":null,"abstract":"<div><h3>Introduction</h3><div>Pulmonary aspiration of gastric contents is a major perioperative complication with a mortality rate of 75% and severe morbidity of 14%. The risk increases in emergency surgeries and gastric ultrasound may be useful to establish gastric content and inform aspiration risk assessment. In this study we describe the degree of agreement between pre-surgical clinical evaluation and gastric ultrasound, in the identification of full stomach in adult patients requiring emergency surgery.</div></div><div><h3>Materials and methods</h3><div>Descriptive observational cross-sectional study of diagnostic tests. The analysis included all adult patients with pathologies requiring emergency surgeries between August 2023 and May 2024 at Hospital Universitario Hernando Moncaleano Perdomo, Neiva, Colombia. The Kappa index was calculated between the 2 tests (clinical evaluation vs. gastric ultrasound), and the level of agreement between them was determined.</div></div><div><h3>Results</h3><div>A total of 57 patients were included in the study. Age, median (range): 51 (18-83), of whom 64.9% were male. The main types of surgeries were general surgery (80.7%), followed by trauma (19.3%). The majority of the population was classified as ASA 3. The most common comorbidities were arterial hypertension and type 2 diabetes mellitus. Fasting time ranged from 12 to 24<!--> <!-->h. There was a high level of agreement among the examiners for determining a full stomach using point-of-care gastric ultrasound, with a concordance level of 0.88 (p<!--> <!-->&lt;<!--> <!-->0.001). In contrast, there was a low level of agreement between the clinical and sonographic evaluation for gastric content assessment, with a concordance level of −0.03 (p<!--> <!-->=<!--> <!-->0.768).</div></div><div><h3>Conclusion</h3><div>Our results suggest that gastric ultrasound has a high level of reproducibility in the emergency surgical setting and can provide information beyond the clinical assessment.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501994"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915380","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":"Reflexiones sobre: «Dolor neuropático y crónico de nueva aparición en supervivientes de COVID-19 grave: análisis secundario del ensayo PAIN-COVID»","authors":"A. Alcántara Montero ,&nbsp;P.J. Ibor Vidal","doi":"10.1016/j.redar.2025.501996","DOIUrl":"10.1016/j.redar.2025.501996","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501996"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915360","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":"¡Historia complicada de una complicación citada!","authors":"R. Magoon ,&nbsp;V. Suresh","doi":"10.1016/j.redar.2025.501898","DOIUrl":"10.1016/j.redar.2025.501898","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501898"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617565","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}