Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Parada cardiorrespiratoria durante la cirugía de trasplante hepático: implicación del beta-bloqueo perioperatorio en el paciente cirrótico","authors":"R.C. Vela Pascual,&nbsp;J.M. Pérez Peña,&nbsp;A. Elvira Rodríguez,&nbsp;M. Power Esteban,&nbsp;C. Jimeno Fernández,&nbsp;J.A. Varela Cabo","doi":"10.1016/j.redar.2024.06.004","DOIUrl":"10.1016/j.redar.2024.06.004","url":null,"abstract":"<div><div>Liver transplantation (LT) has an incidence of intraoperative cardiopulmonary arrest (CPA) of around 5%. Patients who experience CPA during this procedure have a reduced survival rate of approximately 50%.</div><div>Most CPA occur during the neohepatic phase due to reperfusion syndrome, but this is not always the underlying cause, and a broad differential diagnosis must be performed.</div><div>We introduce the case of a cirrhotic patient who received beta-blocker therapy in the preoperative period and who experienced intraoperative CPA during liver transplantation surgery, which was successfully resolved through advanced cardiopulmonary resuscitation maneuvers and specific treatment for beta-blocker toxicity (calcium and glucagon).</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 101645"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167733","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":"Prevalencia del síndrome de burnout en los anestesiólogos europeos y norteamericanos: una revisión sistemática y metaanálisis","authors":"E. Gili-Ortiz ,&nbsp;D. Franco-Fernández ,&nbsp;O. Loli-Aznarán ,&nbsp;M. Gili-Miner","doi":"10.1016/j.redar.2024.501665","DOIUrl":"10.1016/j.redar.2024.501665","url":null,"abstract":"<div><h3>Aims</h3><div>The prevalence of burnout syndrome dimensions in anesthesiologists show notable international differences. In this study, mean prevalences of European and North American anesthesiologists are compared.</div></div><div><h3>Methods</h3><div>Quantitative systematic review (meta-analysis) following the PRISMA and MOOSE criteria. Only studies made with the Maslach Burnout Inventory that includes a Human Services Survey (MBI-HSS) were included. The quality of the studies was evaluated with a modified Newcastle-Ottawa scale, which was used in the meta-regression analyzes together with the Healthcare Access and Quality Index (HAQI) and Gross National Income (GNI) indicators for each country. Publication bias due to small size studies was evaluated with the Egger test.</div></div><div><h3>Results</h3><div>The means of Emotional Exhaustion and Depersonalization were lower in anesthesiologists from Western Europe than in those from Eastern Europe and North America, but the differences were only statistically significant in the Emotional Exhaustion dimension. Meta-regression results were not statistically significant in any of the burnout dimensions for any of the three moderating variables. The test for publication bias was not statistically significant in any of the three dimensions.</div></div><div><h3>Conclusions</h3><div>Based on the results of the meta-analysis and the information from the included studies, social and organizational factors are the most important etiological factors that explain the differences in prevalence. Some of them are related specifically to Eastern Europe and other factors are more relevant in North America. These differences are discussed in this paper.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 501665"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167735","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":"¿Alguna novedad en el tratamiento farmacológico de la neuralgia del trigémino?","authors":"A. Alcántara Montero ,&nbsp;C. Álamo González","doi":"10.1016/j.redar.2024.501668","DOIUrl":"10.1016/j.redar.2024.501668","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 501668"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167730","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":"Factores de ventilación potencialmente modificables asociados a los resultados de los pacientes neurocríticos frente a los no neurocríticos: fundamento y protocolo para el análisis desde el nivel del paciente de PRoVENT, PRoVENT-iMiC y ENIO (PRIME)","authors":"S.C. Serafini ,&nbsp;R. Cinotti ,&nbsp;K. Asehnoune ,&nbsp;D. Battaglini ,&nbsp;C. Robba ,&nbsp;A.S. Neto ,&nbsp;L. Pisani ,&nbsp;G. Mazzinari ,&nbsp;E.M. Tschernko ,&nbsp;M.J. Schultz ,&nbsp;para el PRoVENT, el PRoVENT–iMiC y ENIO, los investigadores","doi":"10.1016/j.redar.2024.501690","DOIUrl":"10.1016/j.redar.2024.501690","url":null,"abstract":"<div><h3>Introduction</h3><div>Ventilator settings and ventilation variables and parameters vary between neurocritical care and non-neurocritical care patients. We aim to compare ventilation management in neurocritical care patients versus non-neurocritical care patients under invasive mechanical ventilation support, and to determine which factors related to ventilatory management have an independent association with outcome in neurocritical patients.</div></div><div><h3>Methods and analysis</h3><div>We meta-analyze harmonized individual patient data from 3 observational studies (PRactice of VENTilation in critically ill patients without ARDS [PRoVENT], PRactice of VENTilation in critically ill patients in Middle-income Countries [PRoVENT-iMiC] and Extubation strategies and in neuro-intensive care unit patients and associations with outcomes [ENIO]), pooled into a database named PRIME. The primary endpoint is all cause ICU mortality. Secondary endpoints are key ventilator settings and ventilation variables and parameters. To identify potentially modifiable and non-modifiable factors contributing to ICU mortality, a multivariable model will be built using demographic factors, comorbidities, illness severities, and respiratory and laboratorial variables. In analyses examining the impact of ventilatory variables on outcome, we will estimate the relative risk of ICU mortality for neurocritical and non-neurocritical care patients by dividing the study population based on key ventilator variables and parameters.</div></div><div><h3>Ethics and dissemination</h3><div>This meta-analysis will address a clinically significant research question by comparing neurocritical care with non-neurocritical care patients. As this is a meta-analysis, additional ethical committee approval is not required. Findings will be disseminated to the scientific community through abstracts and original articles in peer-reviewed journals. Furthermore, the PRIME database will be made accessible for further post-hoc analyses.</div></div><div><h3>Registration</h3><div>PRoVENT, PRoVENT-iMiC and ENIO, and the pooled database PRIME are registered at clinicaltrials.gov (NCT01868321 for PRoVENT, NCT03188770 for PRoVENT-iMiC, and NCT03400904 for ENIO, and for PRIME is pending).</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 5","pages":"Article 501690"},"PeriodicalIF":0.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881940","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 neuroanestesiológico de la rotura carotídea en el abordaje endoscópico endonasal a la base del cráneo","authors":"F. Iturri Clavero ,&nbsp;I. Ingelmo Ingelmo ,&nbsp;K. de Orte Sancho ,&nbsp;M.P. Valcarcel Fernández ,&nbsp;G. Catalán Uribarrena ,&nbsp;F. Valcarcel Martín ,&nbsp;O. Prieto Calderón ,&nbsp;E.M. González Díaz ,&nbsp;A. Uresandi Iruin","doi":"10.1016/j.redar.2024.501691","DOIUrl":"10.1016/j.redar.2024.501691","url":null,"abstract":"<div><div>The medical literature on perioperative anesthesiological care of carotid artery rupture in endoscopic endonasal skull base surgery is practically non-existent. This type of neurovascular injury combines a relatively low incidence with a non-negligible morbidity and mortality. It also requires coordinated multidisciplinary treatment to minimize brain injury induced by inadequate therapeutic management.</div><div>This article presents a series of clinical recommendations and an algorithm for perioperative neuroanesthesiological care of this serious complication.</div><div>To prepare them, a group consisting of 5<!--> <!-->neuroanesthesiologists, a neurosurgeon, an otorhinolaryngologist, a neuroradiologist, and a hematologist reviewed the limited literature on anesthesiological care of this complication. In addition, they adapted anesthesiological care in neurosurgical scenarios similar to the treatment of carotid artery rupture during endoscopic skull base surgery.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 5","pages":"Article 501691"},"PeriodicalIF":0.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882054","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":"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}