Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Anesthetic management of pregnant women with skeletal dysplasia and short stature: a case report","authors":"Á. Barranco de Santiago,&nbsp;Á. Alandes-Gallego,&nbsp;I. García-Rojas,&nbsp;B. Tena,&nbsp;M. Magaldi","doi":"10.1016/j.redare.2024.101625","DOIUrl":"10.1016/j.redare.2024.101625","url":null,"abstract":"<div><div>Skeletal dysplasias and short stature are a heterogeneous group of pathologies in which achondroplasia is the most common presentation. The presence of bone deformities leads to thoracic and airway changes that can complicate ventilation and airway management. Most individuals with skeletal dysplasia present spinal abnormalities that increase the difficulty of administering neuraxial anaesthesia. In pregnant patients, physiological and anatomical changes further complicate obstetric and anaesthesia management.</div><div>We report the case of a patient with skeletal dysplasia and short stature who was admitted to our hospital in week 34.3 of her pregnancy due to labour and respiratory difficulties. It was decided to perform an emergency caesarean section due to the disproportionate size of the foetal head with respect to the pelvis. We also review the different anaesthesia techniques described in the literature, and discuss their potential advantages and difficulties.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 101625"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857487","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":"Monitoring of nociception by NoL Index and its implication in the reduction of opioid complications in laparoscopic abdominal surgery (SIMONE study): Protocol of a prospective, multicentre, observational cohort study.","authors":"A M Pascual-Bellosta, C Aragón-Benedí, S M Ortega-Lucea, L Mínguez-Braulio, M Buey-Aguilar, A Abad-Gurumeta, E Tamayo-Gómez, J Martinez-Ubieto","doi":"10.1016/j.redare.2025.501729","DOIUrl":"10.1016/j.redare.2025.501729","url":null,"abstract":"<p><strong>Background and objectives: </strong>Nociception monitoring allows for the titration of opioid drugs in the intraoperative period in order to avoid under- and overdosing of these drugs and their side effects in the patient's postoperative period. For this reason, a study has been designed with the aim of establishing whether the usefulness of the NoL® (Nociception Level) device for adequate intraoperative nociception monitoring can reduce postoperative complications.</p><p><strong>Material and methods: </strong>Multicentre, observational, prospective cohort study that will include patients who underwent laparoscopic abdominal surgery under balanced general anaesthesia during one year in different hospital centres in order to assess the incidence of early and late postoperative complications and their relationship with the monitoring of nociception studied through the NoL device. Intraoperative pain management will be based on NoL values (visible NoL group) or hemodynamic parameters according to usual clinical practice (non-visible NoL group).</p><p><strong>Results: </strong>Approval has been obtained from the Autonomous Research Ethics Committee of Aragon (C.I. EPA23/026, 19 April 2023). Simone Studio was registered at www.</p><p><strong>Clinicaltrials: </strong>gov on 30 May 2024 (Identifier: NCT06437743).</p><p><strong>Conclusions: </strong>The overall data will be published in peer-reviewed journals. The relevance of the SIMONE study lies in being the first nationwide to comprehensively evaluate opioid dosing, postoperative pain, early and late postoperative complications, and the length of hospital stay. A significant reduction in the incidence of postoperative complications such as nausea and vomiting is expected in the group with visible NoL monitoring.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501729"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495132","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":"Comments on the article \"Mean airway pressure as a parameter of lung-protective and heart-protective ventilation\" by Placenti A, Fratebianchi F.","authors":"M de la Matta, D López-Herrera","doi":"10.1016/j.redare.2025.501734","DOIUrl":"10.1016/j.redare.2025.501734","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501734"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495129","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":"Estimation of minimum effective volume 90% (MEV90) of 0.5% Ropivacaine® in ultrasound-guided interscalene nerve block for postoperative analgesia in arthroscopic shoulder surgery: A prospective observational dose finding study and assessment of diaprhagmatic function.","authors":"B Moreno, V Domingo, M Granell, J M Palanca, S Selfa","doi":"10.1016/j.redare.2025.501731","DOIUrl":"10.1016/j.redare.2025.501731","url":null,"abstract":"<p><strong>Background and objectives: </strong>Ultrasound-guided ISB is the most widely-used nerve block in upper limb surgery. The aim of this study was to determine the MEV90 of 0.5% ropivacaine in ISB for analgesia in arthroscopic shoulder surgery.</p><p><strong>Methodology: </strong>Double-blind observational post-authorization study of a medicinal product for human use. Thirty-two ASA I-III patients aged between 18 and 75 years undergoing arthroscopic shoulder surgery were recruited. We used the Dixon up-down method, whereby the dose is increased or decreased by 1 ml depending on the failure or success of the block. The initial dose was 20 ml of 0.5% ropivacaine. The study was stopped after achieving the minimum 5 negative-positive deflections. Secondary variables were the duration of the block, total analgesia consumption over the first 24 h, and incidence of DP.</p><p><strong>Results: </strong>The effective LA dose for postoperative analgesia in arthroscopic shoulder surgery was 6.8 ml in 50% of patients (MEV50) (90% CI 6.234-7.465) and 7.733 ml in 90% of patients (MEV90) (90% CI 7.393-9.109). Median sensory block duration was 772.5 min. The incidence of partial and total DP in QB was 34% and 41%, respectively.</p><p><strong>Conclusion: </strong>A dose of 7.733 ml of 0.5% ropivacaine provides effective postoperative analgesia in arthroscopic shoulder surgery in 90% of patients. This lower dose reduces the likelihood of side effects.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501731"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495130","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":"Intercostal serratus plane block versus posterior quadratuus lumbar block in laparoscopic nephrectomy: A randomized, controlled, double-blind study.","authors":"M T Fernandez Martin, M G Matesanz, J Andres, H Muñoz, M F Muñoz, A Fadrique, P Castillo, P Casas, S Lopez","doi":"10.1016/j.redare.2025.501728","DOIUrl":"10.1016/j.redare.2025.501728","url":null,"abstract":"<p><strong>Background: </strong>Even though laparoscopic nephrectomy improves the quality of postoperative recovery, it still causes moderate to severe pain. Our objective was to determine whether serratus intercostal plane block (SIPB) was noninferior to posterior quadratus lumborum block (QLB) in terms of pain control and quality of recovery.</p><p><strong>Methods: </strong>This multicentre, controlled, randomized, blinded study had a sample size of 120 patients who were randomly assigned to SIPB, QLB, and control groups prior to scheduled laparoscopic nephrectomy. We collected the following variables: postoperative dynamic pain scores at 0, 6, 12, and 24 h, postoperative quality of recovery (QoR15), and total opioid consumption (fentanyl and morphine).</p><p><strong>Results: </strong>Our results show that SIPB was non-inferior to QLB with regard to the primary endpoint (NRS 0.4/0.9) and quality of recovery (QoR15 112.7/106.85) (p 0.27). Opioid consumption (fentanyl p 0.37 and morphine p 0.9) was similar in the SIPB and QLB groups, and both groups were superior to controls in terms of intraoperative fentanyl consumption (p 0.001) and pain control (p < 0.001).</p><p><strong>Conclusions: </strong>SIPB and QLB showed adequate postoperative pain control, good quality of recovery and lower fentanyl consumption, especially compared to the control group.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501728"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495131","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":"Postoperative anaemia is associated with poor long term postoperative outcomes after elective colorectal oncologic surgery within an enhanced recovery after surgery pathway.","authors":"J Ripollés-Melchor, A Abad-Motos, M L Fuenmayor-Valera, A Ruiz-Escobar, A Abad-Gurumeta, G Paseiro-Crespo, P Fernández-Valdés-Bango, A León-Bretscher, P Soto-García, C Jericó-Alba, J A García-Erce","doi":"10.1016/j.redare.2025.501724","DOIUrl":"10.1016/j.redare.2025.501724","url":null,"abstract":"<p><strong>Background: </strong>Anaemia is an independent risk factor for poor perioperative outcomes after major abdominal surgery, and is associated with an increased risk of 30-day postoperative mortality after noncardiac surgery.</p><p><strong>Objective: </strong>To investigate the frequency of postoperative anaemia and short- and long-term survival after colorectal oncologic surgery at a centre with a well-established Enhanced Recovery After Surgery (ERAS) program.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all patients undergoing elective colorectal oncologic surgery within an ERAS pathway at our institution between 2013 and 2017. Overall survival was calculated with the Kaplan-Meier log rank method and Cox proportional hazard regression based on anaemia at hospital discharge.</p><p><strong>Results: </strong>A total of 680 patients were included. Patients with anaemia at discharge showed a lower overall survival at 5 years (53.9% vs. 44%, p 0.05). Patients who were anaemic at discharge had a lower 5-year overall survival (hazard ratio [HR] 95% CI 2.663 [1.619-4.379], p < 0.001). Kaplan-Meier survival and Cox regression proportional hazard survival for overall survival in the combined preoperative, postoperative, and RBC transfusion model were 1.55 (1.038 2.318) p = 0.032.</p><p><strong>Conclusions: </strong>The combined prognostic value of preoperative anaemia, postoperative anaemia, and blood transfusion created a 40.7% higher risk of not surviving 5 years.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501724"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470398","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 haemoglobin as a predictor of in-hospital morbidity and 5-year mortality in colorectal cancer.","authors":"A Herrero García, S E Denis Filippini, A de la Fuente, E Choolani Bhojwani, J Sánchez González, M Bailón Cuadrado, S Veleda Belanche, V Simó Fernández, J A García Erce, C Aldecoa Álvarez-Santullano","doi":"10.1016/j.redare.2025.501723","DOIUrl":"10.1016/j.redare.2025.501723","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is the third most diagnosed cancer worldwide. Preoperative anaemia is common in CRC patients undergoing surgery.</p><p><strong>Objective: </strong>This study assesses the prevalence of preoperative anaemia and its impact on postoperative outcomes, and aims to establish a cut-off point for increased morbidity and mortality in a large prospective single centre cohort.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 1105 CRC patients (2014-2021). Anaemia was defined as per WHO criteria. Multivariate logistic regression and Kaplan-Meier survival analyses were used. The statistical significance level was set at <0.05.</p><p><strong>Results: </strong>Preoperative anaemia was present in 45.3% of patients, and was associated with a higher incidence of perioperative complications (OR 2.76, p = 0.011) and lower 5-year survival (73% vs 87%, p < 0.001.</p><p><strong>Discussion/conclusions: </strong>Preoperative anaemia, even when mild, is associated with a higher rate of complications, longer hospital stay, and a greater risk of 5-year mortality.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501723"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461101","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":"Underbody carbon-fiber contact warming versus underbody forced-air warming to prevent hypothermia during laparoscopic gynecologic surgery: A randomized trial.","authors":"M Chanzá, M Núñez, M C Velasco, C Rodríguez-Cosmen, A C Carpintero, L Gallart","doi":"10.1016/j.redare.2025.501689","DOIUrl":"10.1016/j.redare.2025.501689","url":null,"abstract":"<p><strong>Background: </strong>Studies comparing intraoperative warming devices report discordant or out-of-date results. This trial compared two underbody warming devices.</p><p><strong>Methods: </strong>Thirty patients undergoing elective prolonged laparoscopic gynecologic surgery were randomized to underbody warming by forced air (n = 15) or contact with a carbon fibre 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, t-tests, and mixed effects models as appropriate.</p><p><strong>Results: </strong>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] vs 36.3 °C [35.9, 36.6] and 36.6 °C [36.2, 36.8] vs 36.3 °C [35.6, 36.5]). Temperature slightly increased over time in the forced-air group and slightly decreased in contact group (0.11 °C/h (0.02, 0.19) vs -0.05 °C/h (-0.13, 0.03), p = 0.008). A single patient required rescue warming (in contact group after 4.75 h). Surgery took longer in the contact group (3.2 h [2.5, 3.8] vs 4.0 h [2.9, 5.6] h, p = 0.042). Two surgeons complained of dizziness related to ambient heat in the forced-air group. No differences were found in the remaining variables.</p><p><strong>Conclusions: </strong>During use of the underbody forced-air and carbon-fibre 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.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501689"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442975","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":"Potentially modifiable ventilation factors associated with outcome in neurocritical care vs. non-neurocritical care patients: Rational and protocol for a patient-level analysis of PRoVENT, PRoVENT-iMiC and ENIO (PRIME).","authors":"S C Serafini, R Cinotti, K Asehnoune, D Battaglini, C Robba, A S Neto, L Pisani, G Mazzinari, E M Tschernko, M J Schultz","doi":"10.1016/j.redare.2025.501690","DOIUrl":"10.1016/j.redare.2025.501690","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods and analysis: </strong>We meta-analyze harmonized individual patient data from three 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.</p><p><strong>Ethics and dissemination: </strong>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.</p><p><strong>Registration: </strong>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).</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501690"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442974","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":"External cephalic version and neuroaxial analgesia. A secondary analysis.","authors":"H J Lacassie, L Basso, L Marfán, M Astete","doi":"10.1016/j.redare.2025.501663","DOIUrl":"10.1016/j.redare.2025.501663","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501663"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434741","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}