Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Las inyecciones de plasma rico en plaquetas mejoran los resultados funcionales en comparación con la radiofrecuencia pulsada mediante bloqueo del ganglio impar en el tratamiento de la coxigodinia","authors":"J. Pilco Inga ,&nbsp;A. Fervienza Sánchez ,&nbsp;J.J. Velázquez Fragoso ,&nbsp;M. Fa-Binefa ,&nbsp;I. Moya Molinas","doi":"10.1016/j.redar.2025.501929","DOIUrl":"10.1016/j.redar.2025.501929","url":null,"abstract":"<div><h3>Background and aim</h3><div>Coccydynia is a painful condition commonly related to trauma or repetitive stress. While most cases respond to conservative management, a subset of patients requires minimally invasive interventions. Platelet-rich plasma (PRP) has recently emerged as a biological treatment alternative, promoting tissue repair. This study aimed to compare the clinical efficacy of PRP injections versus pulsed radiofrequency (PRF) at the ganglion impar in patients with coccydynia refractory to conservative treatment.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted on 40 consecutive patients treated for coccydynia. 20 received PRP injections and 20 underwent PRF at the ganglion impar. Functional disability was measured by the Oswestry Disability Index (ODI) and pain intensity was assessed using the Visual Analogue Scale (VAS) at baseline and at six months. Statistical analysis included t-tests and multivariable regression models adjusted for baseline characteristics.</div></div><div><h3>Results</h3><div>Both groups showed improvement in pain and function. There were no significant differences in pre- or post-treatment VAS scores between the two groups. However, the mean change in ODI scores was significantly greater in the PRP group (−9.6<!--> <!-->±<!--> <!-->4.2) compared to the PRF group (−5.4<!--> <!-->±<!--> <!-->6.3), with a statistically significant difference in functional improvement (p<!--> <!-->=<!--> <!-->0.018), and a clinically relevant improvement (≥<!--> <!-->30% reduction in ODI) was achieved in 85% of cases versus 45%, respectively (p<!--> <!-->=<!--> <!-->0.02). The adjusted analysis confirmed the superiority of PRP after controlling for baseline differences.</div></div><div><h3>Conclusions</h3><div>PRP injections at the ganglion impar demonstrated superior improvement in functional outcomes compared to PRF in patients with refractory coccydynia. These findings support the use of PRP as a potentially more effective minimally invasive treatment, though prospective studies with longer follow-up are needed to confirm these results.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501929"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617561","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":"Retos de la anestesiología: estenosis subglótica severa","authors":"L. Gómez-López,&nbsp;R. Bergé Ramos,&nbsp;A. Vallejo Tarrat,&nbsp;J. Doménech de la Lastra","doi":"10.1016/j.redar.2025.501842","DOIUrl":"10.1016/j.redar.2025.501842","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501842"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617488","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 coronario agudo debido a compresión coronaria por gran aneurisma del seno de Valsalva","authors":"B. Segura-Méndez,&nbsp;R. Bernal-Esteban,&nbsp;N. Arce-Ramos,&nbsp;Y. Carrascal","doi":"10.1016/j.redar.2025.501876","DOIUrl":"10.1016/j.redar.2025.501876","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501876"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617489","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":"Diagnóstico de síndrome de embolia grasa paradójica tras artroplastia de cadera cementada","authors":"S. Maia ,&nbsp;A. Carneiro ,&nbsp;M. Vargas ,&nbsp;B. Xavier ,&nbsp;S. Caramelo","doi":"10.1016/j.redar.2025.501841","DOIUrl":"10.1016/j.redar.2025.501841","url":null,"abstract":"<div><div>The diagnosis of cerebral fat embolism syndrome (FES) is not linear. In this case report, a 79-year-old woman underwent urgent cemented hip arthroplasty 24 hours after a femoral neck fracture. Immediately after the procedure she had a brief episode of altered state of consciousness. After four hours, she presented with multiple neurological symptoms which led to the activation of the stroke alert system. New and diverse neurological deficits appeared during the day. She had two brain CT scan done, which were normal. Transthoracic echocardiogram showed an exuberant patent foramen ovale. Electroencephalogram showed nonconvulsive status epilepticus, which was promptly treated. Brain MRI showed findings compatible with cerebral FES. After initial exclusion of an acute ischemic stroke, conditions that lead to multiple embolic strokes in different vascular territories had to be considered due to the diverse neurological deficits present. The hypothesis of embolization was also supported by the sudden onset of the illness. Even though FES is an exclusion diagnosis, fat microembolism have distinct radiographic features on the brain MRI, which were found on this patient. Perioperative neurological deficits are not uncommon, particularly in the older population. Accurate diagnosis and appropriate management are crucial to ensuring favourable outcomes and preventing long-term sequelae.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501841"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617465","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":"Reversión del bloqueo del nervio frénico con solución salina tras bloqueo interescalénico: reporte de un caso","authors":"A.M. Castro-Alemán,&nbsp;J.A. Estupiñán-Tibaduiza,&nbsp;R.P. Altamirano-Muñoz,&nbsp;J.C. Altuve-Quiroz","doi":"10.1016/j.redar.2025.501851","DOIUrl":"10.1016/j.redar.2025.501851","url":null,"abstract":"<div><div>Brachial plexus block at the interscalene level is a regional anesthetic technique widely used to provide analgesia in shoulder and upper extremity surgery; However, it is associated with a high incidence of phrenic nerve block with diaphragmatic paralysis which has clinical implications in patients with underlying respiratory disease, showing respiratory difficulty symptoms. As consequence, it has been contraindicated in certain population groups. Once diaphragmatic paralysis and respiratory symptoms are established, management is supportive and expectant. In recent years, the administration or “washing” with normal saline solution has been described with the same approach, to reverse the phrenic nerve block and thus the respiratory symptoms. We present the first case of successful reversal of phrenic nerve block with saline in Latin America.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501851"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617466","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 ecoguiado SFO de punción única (SP-SFO): dispersión de la tinción en cadáveres","authors":"S. Diwan ,&nbsp;V. Sathe ,&nbsp;A. Sabnis ,&nbsp;P. Mane ,&nbsp;A. Gupta","doi":"10.1016/j.redar.2025.501951","DOIUrl":"10.1016/j.redar.2025.501951","url":null,"abstract":"<div><h3>Background</h3><div>The terminal nerves of the lumbar plexus, the femoral and obturator nerves, and the sciatic nerve are situated in different fascial planes on the medial side of the thigh. Attempts have been made to approach these nerves using a single puncture from the anterior and medial aspect of the thigh. The previously described SOFT block requires multiple transducer positions, needle redirections, and punctures. We attempted a novel single-puncture, single-position approach to all 3<!--> <!-->nerves in different fascial planes in 6<!--> <!-->soft embalmed cadavers that provided a total of 12<!--> <!-->specimens.</div></div><div><h3>Methods</h3><div>Six fresh human cadavers left at room temperature for a minimum of 6<!--> <!-->hours were positioned supine, and an ultrasound-guided single puncture technique was used to target branches of the sciatic, femoral, and obturator nerves (SP-SFO) and inject 0.1% methylene blue dye. Cross-sections were obtained with a band saw in all cadavers at the level of the SP-SFO injections to observe the spread of the dye in various planes.</div></div><div><h3>Results</h3><div>Cadaver cross-sections showed the spread of the dye in all respective planes. The dye infiltrated the femoral and obturator nerves, while in 4<!--> <!-->specimens it reached the sciatic nerve and the paraneural tissue.</div></div><div><h3>Conclusion</h3><div>This single puncture for branches of the sciatic, femoral, and obturator nerves block (SP-FSO block) can be used to successfully target all these nerves.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501951"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617638","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":"Dolor posquirúrgico y clasificación CIE-11: entre el reconocimiento nosológico y los límites operativos","authors":"A. Alcántara Montero ,&nbsp;A. Montes Pérez","doi":"10.1016/j.redar.2025.501950","DOIUrl":"10.1016/j.redar.2025.501950","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501950"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617559","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":"Sopesar los riesgos: impacto del índice de masa corporal en las complicaciones postoperatorias en la cirugía cardíaca","authors":"A.A. Pupiales-Dávila ,&nbsp;R. Gopar-Nieto ,&nbsp;G. Rojas-Velasco ,&nbsp;D. Manzur-Sandoval","doi":"10.1016/j.redar.2025.501952","DOIUrl":"10.1016/j.redar.2025.501952","url":null,"abstract":"<div><h3>Introduction</h3><div>Body mass index (BMI) is a key determinant of cardiovascular risk and may significantly impact postoperative outcomes. This study aimed to evaluate the relationship between BMI and early postoperative complications in patients undergoing cardiac surgery.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed data from 555 patients who underwent cardiac surgery at the National Institute of Cardiology from June 2022 to December 2023. Patients were categorized into 4 BMI groups: underweight, normal weight, overweight, and obese. Data on demographics, surgical procedures, postoperative complications, and hemodynamic parameters were collected and analyzed.</div></div><div><h3>Results</h3><div>Preoperative comorbidities, including chronic heart failure and fibrilación auricular, were more common among underweight patients. This group was also at higher risk of poscardiotomy low output syndrome (univariate OR 3.35, <em>P</em>=.03), and postoperative fibrilación auricular remained significant in multivariate analysis (OR 1.48, <em>P</em>=.01), and required increased vasopressor and inotropic support. Obese patients had a significantly increased risk of postoperative mediastinitis in both univariate (OR 2.47, <em>P</em>=.04) and multivariate analyses (OR 2.12, <em>P</em>=.03). In-hospital mortality was 14.3% in underweight vs. 6.1% in obese patients (<em>P</em>=.52).</div></div><div><h3>Conclusions</h3><div>This study highlights the significant impact of BMI on postoperative outcomes in cardiac surgery. Underweight patients exhibited higher rates of postoperative complications and mortality, likely due to underlying comorbidities and limited physiological reserves. While obesity is associated with increased cardiovascular risk, our findings suggest a potential obesity paradox in this cohort. Further research is needed to elucidate the underlying mechanisms and refine risk stratification models incorporating BMI and other relevant factors.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501952"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617563","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: «Comparación de los bloqueos en el plano de los músculos serrato y erector de la columna para analgesia postoperatoria en la cirugía de mama unilateral»","authors":"R.M. Sethuraman,&nbsp;R. Aravindan,&nbsp;Y. Mariam","doi":"10.1016/j.redar.2025.501927","DOIUrl":"10.1016/j.redar.2025.501927","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501927"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617566","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":"Dolor crónico tras trasplante hepático: estudio transversal","authors":"A. Duarte,&nbsp;F. Farias,&nbsp;V. Pires,&nbsp;R. Poeira,&nbsp;M. Canas","doi":"10.1016/j.redar.2025.501953","DOIUrl":"10.1016/j.redar.2025.501953","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic post-surgical pain (CPSP) is a major concern following liver transplantation. Despite advancements in surgical and anaesthesia techniques, CPSP remains prevalent and under-researched.</div></div><div><h3>Methods</h3><div>This cross-sectional retrospective study was conducted at Hospital Curry Cabral, Lisbon, Portugal, in patients who underwent liver transplantation between January 2017 and December 2021. A total of 310 patients participated, exceeding the minimum sample size of 247 required for statistical significance. Data were collected from questionnaires administered over the phone — the Brief Pain Inventory Short Form (BPI-SF) and the Douleur Neuropathique en 4 Questions (DN4) — and from a review of each patient's clinical history.</div></div><div><h3>Results</h3><div>CPSP was identified in 20.0% of patients, with a higher prevalence in women (27.6%) compared to men (17.0%) (odds ratio: 1.85; 95% confidence interval: 1.03-3.33; <em>P</em> <!-->=<!--> <!-->.019). Acute postoperative pain and female gender were significant independent predictors. Neuropathic pain characteristics were present in 25.8% of cases. We found that CPSP significantly interfered with daily activities, but despite its high incidence, only 24.2% of patients were receiving treatment for their pain.</div></div><div><h3>Discussion</h3><div>Our findings highlight the impact of CPSP on liver transplant recipients and the need for improved pain management. The study underscores the importance of addressing acute postoperative pain to prevent the development of CPSP and calls for heightened awareness and better treatment protocols to enhance outcones.</div></div><div><h3>Conclusion</h3><div>This study provides insights into the prevalence and impact of CPSP among liver transplant patients, and identifies acute postoperative pain and female gender as risk factors. The results show the need to improve pain management practices in order to mitigate the long-term effects of CPSP.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 10","pages":"Article 501953"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617464","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}