Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Inter-observer reliability of gastric ultrasound and level of agreement with clinical evaluation in adult patients requiring emergency surgery","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.redare.2026.501994","DOIUrl":"10.1016/j.redare.2026.501994","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 two 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 hours. There was a high level of agreement among the examiners for determining a full stomach using point-of-care (POCUS) 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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 1","pages":"Article 501994"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986117","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":"Beyond compliance: Patient risk, ERAS adherence, and postoperative outcomes through explainable machine learning","authors":"J. Ripollés-Melchor ,&nbsp;Á.V. Espinosa ,&nbsp;A. Abad-Motos ,&nbsp;A. Abad-Gurumeta ,&nbsp;P. Galán-Menéndez ,&nbsp;A. Zorrilla-Vaca ,&nbsp;R. Navarro-Pérez ,&nbsp;A. Ruiz-Escobar ,&nbsp;J. Fernanz-Antón ,&nbsp;A. Suárez-de-la-Rica ,&nbsp;C. Aldecoa ,&nbsp;the EuroPOWER Study Investigators Group","doi":"10.1016/j.redare.2026.501990","DOIUrl":"10.1016/j.redare.2026.501990","url":null,"abstract":"<div><h3>Background</h3><div>Enhanced Recovery After Surgery (ERAS) protocols improve outcomes after colorectal surgery, but adherence remains variable and may interact with patient risk. Traditional compliance scores lack granularity to explore these dynamics. We aimed to use interpretable machine learning to quantify the contribution of individual ERAS items and clinical features to postoperative complications, and to identify data-driven ERAS phenotypes.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of the EuroPOWER cohort (NCT04889798), a prospective European study including 2841 adults undergoing elective colorectal surgery. Two Extreme Gradient Boosting models were trained to predict in-hospital complications: a complete model (clinical variables + 23 ERAS items) and an ERAS-only model. Both were interpreted using Shapley Additive Explanations (SHAP). In the complete model, SHAP matrices were clustered to derive phenotypes. Feature importance, adherence, and complication rates were compared descriptively.</div></div><div><h3>Results</h3><div>The complete model achieved an AUC of 0.627. SHAP analysis identified frailty, ASA class, BMI, and age as leading predictors, followed by early mobilisation, nutritional care, and thromboprophylaxis. Three phenotypes were identified, with complication rates of 17.7%, 27.1%, and 41.1%, corresponding to robust, intermediate, and frail profiles. The ERAS-only model showed similar discrimination (area under the curve 0.642), but reduced interpretability. SHAP redundancy analysis supported inclusion of all ERAS items.</div></div><div><h3>Conclusions</h3><div>The clinical effect of ERAS adherence appears to be modulated by baseline vulnerability and implementation patterns. SHAP-based models enable transparent risk attribution and phenotype identification, supporting more targeted ERAS strategies and future development of automated quality monitoring tools.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 1","pages":"Article 501990"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946955","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":"Reflections on: «New-onset chronic and neuropathic pain in survivors of severe COVID-19: A secondary analysis of the PAIN-COVID Trial»","authors":"A. Alcántara Montero ,&nbsp;P.J. Ibor Vidal","doi":"10.1016/j.redare.2025.501996","DOIUrl":"10.1016/j.redare.2025.501996","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 1","pages":"Article 501996"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759001","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":"Use of saline solution to reverse interscalene block-induced phrenic nerve palsy: A case report","authors":"A.M. Castro-Alemán,&nbsp;J.A. Estupiñán-Tibaduiza,&nbsp;R.P. Altamirano-Muñoz,&nbsp;J.C. Altuve-Quiroz","doi":"10.1016/j.redare.2025.501851","DOIUrl":"10.1016/j.redare.2025.501851","url":null,"abstract":"<div><div>Brachial plexus block at the interscalene level is a regional anaesthetic 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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501851"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016998","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":"Preoperative cognitive function assessment: Feasibility and outcomes","authors":"B. Tena,&nbsp;A. Fervienza,&nbsp;I. Gracia,&nbsp;N. Fábregas","doi":"10.1016/j.redare.2025.501857","DOIUrl":"10.1016/j.redare.2025.501857","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501857"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152547","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":"Platelet-rich plasma injections improve functional results over pulsed radiofrequency in ganglion impar treatments for coccydynia","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.redare.2025.501929","DOIUrl":"10.1016/j.redare.2025.501929","url":null,"abstract":"<div><h3>Introduction</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>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 <em>t</em>-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 (<em>p</em> = 0.018), and a clinically relevant improvement (≥30% reduction in ODI) was achieved in 85% of cases versus 45%, respectively (<em>p</em> = 0.02). The adjusted analysis confirmed the superiority of PRP after controlling for baseline differences.</div></div><div><h3>Conclusion</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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501929"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234258","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":"Challenges in anesthesiology: Severe subglottic stenosis","authors":"L. Gómez-López,&nbsp;R. Bergé Ramos,&nbsp;A. Vallejo Tarrat,&nbsp;J. Doménech de la Lastra","doi":"10.1016/j.redare.2025.501842","DOIUrl":"10.1016/j.redare.2025.501842","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501842"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139969","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":"Postsurgical pain and ICD-11 classification: Between nosological recognition and practical constraints","authors":"A. Alcántara Montero ,&nbsp;A. Montes Pérez","doi":"10.1016/j.redare.2025.501950","DOIUrl":"10.1016/j.redare.2025.501950","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501950"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228725","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":"Diagnosing paradoxical fat embolism syndrome after cemented hip arthroplasty","authors":"S. Maia ,&nbsp;A. Carneiro ,&nbsp;M. Vargas ,&nbsp;B. Xavier ,&nbsp;S. Caramelo","doi":"10.1016/j.redare.2025.501841","DOIUrl":"10.1016/j.redare.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 h after a femoral neck fracture. Immediately after the procedure she had a brief episode of altered state of consciousness. After 4 h, she presented with multiple neurological symptoms which led to activation of the stroke alert system. Various new neurological deficits appeared during the day. She had 2 brain CT scans, which were normal. Transthoracic echocardiogram showed a patent foramen ovale with an exuberant aneurysm. Electroencephalogram showed nonconvulsive status epilepticus, which was promptly treated. Brain MRI showed findings compatible with cerebral FES. After ruling out acute ischaemic stroke, conditions that lead to multiple embolic strokes in different vascular territories had to be considered due to the diverse neurological deficits. The embolization hypothesis was also supported by the sudden onset of the symptoms. Even though FES is an exclusion diagnosis, the patient’s brain MRI showed the distinct radiographic features of fat microembolism. Perioperative neurological deficits are not uncommon, particularly in elderly patients. Accurate diagnosis and appropriate management are crucial to ensure favourable outcomes and prevent long-term sequelae.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501841"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139918","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":"Reflections on: “Comparison of serratus plane and erector spinae plane blocks for postoperative analgesia in unilateral breast surgery”","authors":"R. M. Sethuraman,&nbsp;R. Aravindan,&nbsp;Y. Mariam","doi":"10.1016/j.redare.2025.501927","DOIUrl":"10.1016/j.redare.2025.501927","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501927"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016948","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}