Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Perioperative cardiac arrest in obstetric patients","authors":"M. Astete ,&nbsp;H.J. Lacassie ,&nbsp;A. Gálvez","doi":"10.1016/j.redare.2026.502037","DOIUrl":"10.1016/j.redare.2026.502037","url":null,"abstract":"<div><div>Perioperative cardiopulmonary arrest (CPA) in the obstetric patient is a rare but devastating complication, representing a significant clinical challenge due to the speed with which it threatens the lives of the mother and fetus. Although, compared to the general population, obstetric patients have a lower risk due to their youth and fewer comorbidities, recent records show an increase in the incidence of CPA in this group. Anesthetic factors are key, especially when general anesthesia is used, and unexpected conversion from neuraxial blocks poses an additional risk. Success in the management of CPA critically depends on early recognition and a coordinated, structured approach, where understanding the causes and maternal physiology is essential. Emphasizing education specifically dedicated to obstetric CPA is a priority, as conventional approaches like basic and advanced cardiac life support have proven insufficient for the particularities of this setting. To optimize outcomes, it is recommended to train skilled multidisciplinary teams, implement adapted protocols, and carry out timely interventions such as <em>perimortem</em> cesarean section. Effective communication between teams and the application of advanced support measures, always considering maternal and fetal well-being, are decisive factors for prognosis. In summary, perioperative CPA in obstetrics requires specific protocols, ongoing knowledge updates and simulation, with the primary goal of reducing maternal mortality and improving neonatal outcomes in one of the most critical scenarios faced by healthcare teams.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502037"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483218","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":"Post-spinal position and its impact on hemodynamic, block height, and comfort in caesarean delivery: A randomized assessor-blinded trial","authors":"A. Mohamady Eldemrdash,&nbsp;I. Elabd Hassan,&nbsp;A. Youssef Mohamed,&nbsp;H.M. Ahmed Raslan","doi":"10.1016/j.redare.2026.502089","DOIUrl":"10.1016/j.redare.2026.502089","url":null,"abstract":"<div><h3>Background</h3><div>Maternal hypotension is common during spinal anesthesia for cesarean delivery and is influenced by patient position. Positioning also affects sensory block height, which determines visceral analgesia. This study compared immediate supine, sitting, and semi-sitting positions to identify the optimal balance between cardiovascular stability and surgical anesthesia.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, 216 ASA II term parturients scheduled for cesarean delivery under spinal anesthesia were assigned to three groups (n = 72). Group A received immediate supine positioning, Group B sat for three minutes, and Group C assumed semi-sitting for three minutes. All received 2.5 mL of 0.5% hyperbaric bupivacaine. The primary outcome was maternal hypotension; secondary outcomes included block height, intraoperative discomfort, vasopressor use, and neonatal Apgar scores.</div></div><div><h3>Results</h3><div>Hypotension occurred most in Group A (65.3%), followed by Group C (47.2%) and Group B (33.3%) (<em>P</em> &lt; .001). The supine group had 3.79 times higher odds of hypotension compared with sitting. Ephedrine use was greatest in Group A (14.5 ± 3.2 mg) and least in Group B (8.1 ± 2.3 mg). Median block height was T3 in Group A, T5 in Group C, and T6 in Group B. Intraoperative discomfort was highest in Group B (22.2%) compared with Group C (12.5%) and Group A (5.6%) (<em>P</em> = .009). Hypotension correlated with nausea, most frequent in Group A (19.4%). Neonatal Apgar scores were ≥8 at 1 and 5 min in all groups.</div></div><div><h3>Conclusion</h3><div>Maternal position after spinal anesthesia significantly influences hemodynamics and block height. Sitting reduces hypotension but risks lower block and discomfort, while semi-sitting provides a favorable compromise.</div></div><div><h3>Trial registration</h3><div>[NCT06857162].</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502089"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505959","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":"Relationship between mitral annular plane systolic excursion and left ventricular ejection fraction by modified Simpson’s method using point of care cardiac ultrasound: An observational analytical study","authors":"N. Kumar,&nbsp;K. Arya,&nbsp;M. Pandey","doi":"10.1016/j.redare.2026.502088","DOIUrl":"10.1016/j.redare.2026.502088","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to find the relationship between MAPSE and LVEF by modified Simpson’s method using point of care cardiac ultrasound.</div></div><div><h3>Design</h3><div>Prospective observational study.</div></div><div><h3>Setting</h3><div>Intensive care unit.</div></div><div><h3>Patients</h3><div>Seventy-five patients admitted to the intensive care unit were recruited for determining the relationship between MAPSE and LVEF by modified Simpson’s method. It was validated in the second part in another 75 patients by comparing the result obtained from modified Simpson’s method and the previously derived equation.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Measurements</h3><div>MAPSE, LVEF from modified Simpson’s method in part I. An equation was derived from a linear relationship between the two. In part II, the derived equation for calculation of LVEF from MAPSE was validated with respect to a previously described equation and LVEF obtained by modified Simpson’s method. Bias and precision were calculated. Time taken for both the procedures was also noted.</div></div><div><h3>Results</h3><div>MAPSE showed a strong correlation with LVEF calculated by modified Simpson’s method. The linear equation obtained was LVEF = 3.27 × MAPSE (mm) + 18.79 (ρ = 0.761, R² = 0.520). Time taken for calculation of MAPSE was quicker (51.47 ± 11.18 s) as compared to that by modified Simpson’s method (192.27 ± 31.93 s; <em>P</em> &lt; .001). The equation was found to be 89.33% accurate. A MAPSE of 10.325 mm, predicts EF &gt; 50% with a sensitivity of 90.7% and 90.6% specificity.</div></div><div><h3>Conclusion</h3><div>MAPSE correlates well with the EF measured by modified Simpson’s method. It is faster and provides an accurate estimation of ejection fraction.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502088"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492448","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":"Effects of ultrasound-guided caudal versus perianal blocks on intraoperative anal sphincter tone and postoperative analgesia during sphincter-sparing procedures: A randomized comparative trial","authors":"A.M. Adel AbdelMoneim,&nbsp;M. Bassem Helmy,&nbsp;M. Adolf Helmy,&nbsp;O. Mohamed Asaad,&nbsp;A. Hassan Saleh,&nbsp;M.H. El-Sherbiny","doi":"10.1016/j.redare.2026.502091","DOIUrl":"10.1016/j.redare.2026.502091","url":null,"abstract":"<div><h3>Background</h3><div>Data comparing the effects of caudal epidural anaesthesia and perianal block during anal sphincter sparing procedures under general anaesthesia are limited. We aimed to compare the efficacy and safety of ultrasound-guided caudal block versus perianal block on anal sphincter muscle tone and in reducing postoperative pain among patients undergoing anal sphincter-sparing procedures.</div></div><div><h3>Methods</h3><div>This randomized double-blinded study enrolled 46 adult patients, American Society of Anesthesiologists physical status I or II, who underwent anal sphincter sparing procedures under general anaesthesia. Patients were randomly assigned to one of two groups (23 patients each). Group A received an ultrasound-guided caudal block, while Group B received a perianal block. The primary outcome was duration of postoperative analgesia. Secondary outcomes included total postoperative morphine consumption, postoperative pain intensity, time to postoperative ambulation, intraoperative external anal sphincter muscle tone by Digital rectal scoring system (DRESS), patient satisfaction, and incidence of complications.</div></div><div><h3>Results</h3><div>Patients in group A had a statistically significant longer time to first request for analgesia and lower morphine consumption than those in group B (2.50 ± 0.27 vs. 1.57 ± 0.53 h, and 3.30 ± 2.18 mg vs. 5.87 ± 2.05 mg, <em>P</em> &lt; .001). Although these differences are modest in magnitude, they may contribute to improved recovery when combined with multimodal analgesia strategies. Moreover, caudal block resulted in shorter time to ambulation (2.17 ± 0.38 vs 3.48 ± 0.53 h), and low numeric pain scores (1.96 ± 0.56 vs. 3.48 ± 0.66, <em>P</em> &lt; .001). The DRESS and Likert scores were significantly higher in patients in group A than in group B (2.83 ± 0.38 vs. 2.22 ± 0.42, and 3.78 ± 0.42 vs. 2.48 ± 0.66, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>In anal sphincter-sparing operations, ultrasound-guided caudal epidural blocks combined with general anaesthesia may improve pain management, reduce opioid requirements, and thereby reduce the incidence of postoperative nausea and vomiting, while maintaining anal sphincter tone compared to local perianal block.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502091"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492453","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":"Diaphragm-sparing shoulder regional anesthesia techniques: Understanding the concepts and clinical applications","authors":"R.M. Sethuraman","doi":"10.1016/j.redare.2026.502038","DOIUrl":"10.1016/j.redare.2026.502038","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502038"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319431","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":"Anaesthethic management on a pediatric patient with Sengers syndrome. Case report","authors":"M.A. Perelló,&nbsp;F.J. Bellafont,&nbsp;E. Pujol-Ayach,&nbsp;M. Alegret","doi":"10.1016/j.redare.2026.502024","DOIUrl":"10.1016/j.redare.2026.502024","url":null,"abstract":"<div><div>Sengers Syndrome is an autosomal recessive mitochondrial myopathy caused by mutations of the acylglycerol kinase gene, which leads to an abnormal musculoskeletal and myocardial lipid and glycogen accumulation. It is characterized by congenital cataracts, hypertrophic cardiomyopathy, skeletal myopathy and lactic acidosis (especially under stress condition). Therefore, cataract surgery might be indicated. Currently there is no treatment or management formalised for this disease, meaning it is a challenge in clinical practice. We introduce a case of perioperative anaesthetic management on a patient with Sengers Syndrome, considering its interest as it is one of the first known cases undergoing general anaesthesia.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502024"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461380","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":"Forestier's disease: The radiograph that anticipates the difficult airway","authors":"M. Arias Salazar,&nbsp;R. Bergé,&nbsp;A. Cayuso,&nbsp;M. Sangrà-Puig","doi":"10.1016/j.redare.2026.502022","DOIUrl":"10.1016/j.redare.2026.502022","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502022"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461391","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":"Response to Sethuraman et al. regarding “Comparison of single-shot neuraxial morphine and erector spinae plane block on quality of recovery after major open gastrointestinal surgeries”","authors":"A. Choudhary,&nbsp;S. Singh","doi":"10.1016/j.redare.2026.502001","DOIUrl":"10.1016/j.redare.2026.502001","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502001"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483203","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":"Interscalene block versus upper trunk block in shoulder arthroscopy: Randomized comparative study of the ease between the two techniques among residents","authors":"A.M.M. Ahmed,&nbsp;M.A. Moustafa,&nbsp;A.S. Alabd","doi":"10.1016/j.redare.2026.502092","DOIUrl":"10.1016/j.redare.2026.502092","url":null,"abstract":"<div><h3>Introduction</h3><div>Interscalene brachial plexus block (ISB) remains the gold standard nerve block in shoulder arthroscopic surgery. However, some anatomical variations exist in addition to several reported complications and technical challenges. Upper trunk block (UTB) may be a feasible alternative. The primary outcome was the success rate of UTB and ISB. Secondary outcomes included: duration of block performance, guidance interventions, visualization of anatomic structures, postoperative pain and opioid consumption, and diaphragmatic function.</div></div><div><h3>Methods</h3><div>One hundred and twenty patients were divided randomly into 2 groups; 60 patients received ISB before general anaesthesia (GA) and 60 patients received UTB before GA. All blocks were performed by anaesthesia trainees under supervision of an attending consultant.</div></div><div><h3>Results</h3><div>Age, sex, BMI, and duration of surgery were not different statistically. The duration of block performance was significantly longer in the ISB group (P = 0.002). Guidance interventions in the ISB group were higher than the UTB group (P &lt; 0.001). There were no significant differences regarding the worst postoperative pain score (P = 0.574), postoperative nalbuphine consumption (P = 0.813) or success rate (P = 0.31) between groups. Visualization of the anatomic structures in the 2 groups was not statistically significant (P = 0.183). Diaphragmatic function was significantly affected in the ISB group (45% complete paralysis and 35% paresis) versus (8.3% complete paralysis and 30% paresis) in the UTB group.</div></div><div><h3>Conclusions</h3><div>UTB may be considered a safer and a technically easier approach than ISB for providing equivalent intra and postoperative regional analgesia in arthroscopic shoulder surgery by anaesthesia trainees.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502092"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505885","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 and opportunities for personalized analgesia","authors":"S. López Álvarez","doi":"10.1016/j.redare.2026.502031","DOIUrl":"10.1016/j.redare.2026.502031","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502031"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461378","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}