Revista espanola de anestesiologia y reanimacion最新文献_第2页

Transcaval approach for aortic endoprosthesis insertion. A new anesthetic challenge 经腔途径植入主动脉内假体。新的麻醉挑战。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redare.2024.05.003

{"title":"Transcaval approach for aortic endoprosthesis insertion. A new anesthetic challenge","authors":"","doi":"10.1016/j.redare.2024.05.003","DOIUrl":"10.1016/j.redare.2024.05.003","url":null,"abstract":"<div><div>The treatment of acute aortic syndrome has been benefited in recent years from the huge progress in endovascular techniques, compared to classical surgical treatment, by open surgery. Nevertheless, for endovascular treatment to be successful, it is essential for the patient to present adequate vascular access. Those cases with unfavourable vascular anatomy make it necessary to consider open surgery with significant morbidity, or even to reject surgery. A new approach to the abdominal aorta has recently been described as an indication for these patients with impossibility of other vascular access and absolute or relative contraindication to the transthoracic approach.</div><div>The anesthetic management of the aortic syndrome is well known and, even though there are a variety of options, all of them have proven safety and efficacy. The implementation of new surgical approaches and new possible complications imply a challenge for the anesthesiologist which, for now, has little or none scientific evidence.</div><div>We present the first case of transcaval aortic endoprosthesis implantation in Spain, its anesthetic implications, and a review of the literature.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157678","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}

引用次数: 0

The efficacy of the ultrasound-guided retrolaminar block versus the classic paravertebral block in patients undergoing unilateral inguinal hernioplasty: a randomized controlled study 在单侧腹股沟疝成形术患者中，超声引导视网膜阻滞与传统椎旁阻滞的疗效：随机对照研究。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redare.2024.03.008

{"title":"The efficacy of the ultrasound-guided retrolaminar block versus the classic paravertebral block in patients undergoing unilateral inguinal hernioplasty: a randomized controlled study","authors":"","doi":"10.1016/j.redare.2024.03.008","DOIUrl":"10.1016/j.redare.2024.03.008","url":null,"abstract":"<div><h3>Background</h3><div>In daily surgical practice, inguinal hernioplasty<span><span> is a frequent procedure that is frequently accompanied by severe postoperative pain. Multiple regional blocks have been described for analgesia after such operations. Retrolaminar block (RLB) is a paravertebral block (PVB) variant that provides excellent analgesia and reduces the risk of complications. This prospective trial compared the </span>analgesic efficacy of PVB and RLB in the inguinal hernioplasty.</span></div></div><div><h3>Methods</h3><div><span>The 56 patients included were randomly assigned into two equal groups according to the block performed under ultrasound guidance at the T12 level: PVB group (28 patients) and RLB (28 patients). Time until the first rescue analgesia was our primary outcome. Other outcomes included the time to perform the block, changes in intraoperative </span>hemodynamic parameters, postoperative VAS, 24-h morphine consumption, the level of patient satisfaction, and the incidence of block-related complications.</div></div><div><h3>Results</h3><div>Demographic data were comparable in the two groups. However, the time needed for the block was significantly shortened with the RLB (p < 0.001). Patients in the PVB groups expressed better pain scores and lower opioid consumption. Additionally, the time to the first call for opioid analgesia showed a significant prolongation in association with the PVB. There was no discernible difference in the frequency of adverse events and recorded MAP and HR.</div></div><div><h3>Conclusion</h3><div>The PVB has a superior perioperative analgesic profile compared to the RLB, which manifested in the prolonged duration to the first rescue analgesics, better pain scores, and less opioid consumption, with no significant increase in block-related complications.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327546","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}

引用次数: 0

Use of cannabinoids for acute postoperative pain 使用大麻素治疗急性术后疼痛。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redare.2024.05.004

引用次数: 0

Machine learning models based on ultrasound and physical examination for airway assessment 基于超声波和体格检查的气道评估机器学习模型。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redare.2024.05.006

{"title":"Machine learning models based on ultrasound and physical examination for airway assessment","authors":"","doi":"10.1016/j.redare.2024.05.006","DOIUrl":"10.1016/j.redare.2024.05.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To demonstrate the utility of machine learning models for predicting difficult airways using clinical and ultrasound parameters.</div></div><div><h3>Methods</h3><div><span>This is a prospective non-consecutive cohort of patients undergoing elective surgery. We collected as predictor variables age, sex, </span>BMI<span>, OSA, Mallampatti, thyromental distance<span>, bite test, cervical circumference, cervical ultrasound measurements, and Cormack-Lehanne class after laryngoscopy. We univariate analyzed the relationship of the predictor variables with the Cormack-Lehanne class to design machine learning models by applying the random forest technique with each predictor variable separately and in combination. We found each design's AUC-ROC, sensitivity, specificity, and positive and negative predictive values.</span></span></div></div><div><h3>Results</h3><div>We recruited 400 patients. Cormack-Lehanne patients≥III had higher age, BMI, cervical circumference, Mallampati class membership≥III, and bite test≥II and their ultrasound measurements were significantly higher. Machine learning models based on physical examination obtained better AUC-ROC values than ultrasound measurements but without reaching statistical significance. The combination of physical variables that we call the “Classic Model” achieved the highest AUC-ROC value among all the models [0.75 (0.67−0.83)], this difference being statistically significant compared to the rest of the ultrasound models.</div></div><div><h3>Conclusions</h3><div>The use of machine learning models for diagnosing VAD is a real possibility, although it is still in a very preliminary stage of development.</div></div><div><h3>Clinical registry</h3><div>ClinicalTrials.gov: NCT04816435.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201344","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}

引用次数: 0

A comparative study between single injection (corner pocket approach) and double injection costoclavicular block: A randomized parallel arm, non-inferiority trial 单次注射（角袋法）与双次注射肋锁关节阻滞的比较研究：随机平行臂、非劣效试验。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redare.2024.04.009

{"title":"A comparative study between single injection (corner pocket approach) and double injection costoclavicular block: A randomized parallel arm, non-inferiority trial","authors":"","doi":"10.1016/j.redare.2024.04.009","DOIUrl":"10.1016/j.redare.2024.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have shown that ultrasound guided costoclavicular block may require a double shot to provide adequate, rapid sensory and motor blockade. In this trial, we hypothesized that if the corner pocket approach (between axillary artery and median cord) is used instead of the central approach (at the midpoint of the 3 cords) when performing single-shot costoclavicular block, the onset of blockade would be non-inferior to the double-shot technique.</div></div><div><h3>Method</h3><div>Ninety patients undergoing upper limb surgery were randomized to 2 groups for ultrasound-guided costoclavicular block (CCB) at a tertiary hospital. One group received ultrasound guided single-shot CCB using the corner pocket approach and other received ultrasound guided double-shot – the first shot at the centre of the 3 cords and the second between the axillary artery and the median cord. An observer blinded to group assignment recorded blockade onset time (defined as the time required to achieve a minimal sensorimotor composite score of 14 out of 16 points).</div></div><div><h3>Results</h3><div>Of the 101 patients assessed for eligibility, 90 were recruited over period of 1 year (February 2022 to January 2023), with 45 in each group. Onset time was 22.1 ± 3.1 min in the single-shot group and 22.4 ± 2.9 min in the double-shot group. This difference was insignificant (<em>P</em> = .3).</div></div><div><h3>Conclusion</h3><div>Time to onset of blockade and full anaesthesia are similar in single-shot corner pocket CCB vs double-shot CCB. Further studies are required to determine the minimum effective volume of local anaesthetic required for the described technique.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140769428","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}

引用次数: 0

QT-prolongation in patients with severe COVID-19 is multicausal and not limited to anti-SARS-CoV-2 drugs 严重 COVID-19 患者的 QT 延长是多原因造成的，并不局限于抗 SARS-CoV-2 药物。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redare.2024.04.002

引用次数: 0

Risk factors for PPCs in laparoscopic non–robotic vs. laparoscopic robotic abdominal surgery (LapRas): rationale and protocol for a patient–level analysis of LAS VEGAS and AVATaR 腹腔镜非机器人腹部手术 (LapRas) 与腹腔镜机器人腹部手术 (LapRas) 中 PPC 的风险因素：LAS VEGAS 和 AVATaR 患者层面分析的原理和方案。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redare.2024.07.001

{"title":"Risk factors for PPCs in laparoscopic non–robotic vs. laparoscopic robotic abdominal surgery (LapRas): rationale and protocol for a patient–level analysis of LAS VEGAS and AVATaR","authors":"","doi":"10.1016/j.redare.2024.07.001","DOIUrl":"10.1016/j.redare.2024.07.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative pulmonary complications (PPCs) vary amongst different surgical techniques. We aim to compare the incidence of PPCs after laparoscopic non–robotic versus laparoscopic robotic abdominal surgery.</div></div><div><h3>Methods and analysis</h3><div>LapRas (Risk Factors for PPCs in Laparoscopic Non–robotic vs Laparoscopic robotic abdominal surgery) incorporates harmonized data from 2 observational studies on abdominal surgery patients and PPCs: ‘Local ASsessment of VEntilatory management during General Anaesthesia for Surgery’ (LAS VEGAS), and ‘Assessment of Ventilation during general AnesThesia for Robotic surgery' (AVATaR). The primary endpoint is the occurrence of one or more PPCs in the first five postoperative days. Secondary endpoints include the occurrence of each individual PPC, hospital length of stay and in–hospital mortality. Logistic regression models will be used to identify risk factors for PPCs in laparoscopic non–robotic versus laparoscopic robotic abdominal surgery. We will investigate whether differences in the occurrence of PPCs between the two groups are driven by differences in duration of anesthesia and/or the intensity of mechanical ventilation.</div></div><div><h3>Ethics and dissemination</h3><div>This analysis will address a clinically relevant research question comparing laparoscopic and robotic assisted surgery. No additional ethical committee approval is required for this metanalysis. Data will be shared with the scientific community by abstracts and original articles submitted to peer-reviewed journals.</div></div><div><h3>Registration</h3><div>The registration of this post-hoc analysis is pending; individual studies that were merged into the used database were registered at clinicaltrials.gov: LAS VEGAS with identifier NCT01601223, AVATaR with identifier NCT02989415.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581967","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}

引用次数: 0

Extubation failure: Upper airway obstruction by chewing gum. A case report 拔管失败：口香糖导致上气道阻塞。病例报告。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redare.2024.02.006

引用次数: 0

Protocol of a clinical trial on the effectiveness of pudendal nerve block with and without neurostimulation in reducing posthemorroidectomy pain 有无神经刺激的阴部神经阻滞术对减轻肿瘤切除术后疼痛的有效性临床试验方案。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redare.2024.05.005

{"title":"Protocol of a clinical trial on the effectiveness of pudendal nerve block with and without neurostimulation in reducing posthemorroidectomy pain","authors":"","doi":"10.1016/j.redare.2024.05.005","DOIUrl":"10.1016/j.redare.2024.05.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Hemorrhoidal pathology is the most frequent proctological problem with a prevalence of 44% of the adult population. The most effective treatment is surgery but it also has the highest postoperative pain rate with moderate to severe pain rates of 30–40% during the first 24−48 hours. Here lies the importance of seeking measures to improve this situation, such as the pudendal nerve block with local anesthetic. However, the variability of the pudendal nerve sometimes makes its blockade ineffective and for this reason nerve location methods are sought to achieve a higher rate of success. The main aim of the study is to compare pain in the immediate postoperative period (24 h) after hemorrhoidectomy in patients with pudendal nerve block guided by anatomical references and guided by neurostimulation.</div></div><div><h3>Methods</h3><div>The present project proposes the performance of a single-center, triple-blind, randomized clinical trial of efficacy, carried out under conditions of routine clinical practice. Patients over 18 years old with hemorrhoids refractory to medical treatment, symptomatic grade III-IV and grade II hemorrhoids that do not respond to conservative procedures in a third level hospital in Spain and that are subsidiaries of surgery in major ambulatory surgery will be included. Demographic variables, variables on hemorrhoidal pathology, details of surgery, verbal numeric pain scale in the preoperative period and surgical complications will be collected.</div></div><div><h3>Results</h3><div>Not avaliable until the end of the study.</div></div><div><h3>Conclusions</h3><div>The pudendal nerve block guided by anatomical landmarks has been shown to be useful in postoperative pain control after hemorrhoidectomy although the use of the neurostimulator has not been well studied and we believe it may improve outcom</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184977","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}

引用次数: 0

Ganglion impar block in chronic cancer-related pain – A review of the current literature 神经节阻滞治疗慢性癌症相关疼痛--现有文献综述

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-10-01 DOI: 10.1016/j.redare.2024.04.013

引用次数: 0