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

How a single perioperative delirium case can make the difference 一个围手术期谵妄病例是如何产生影响的？

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.04.003

引用次数: 0

Ultrasound monitoring to detect embolic phenomena in the inferior vena cava during hip arthroplasty 髋关节置换术中检测下腔静脉栓塞现象的超声监测。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.04.017

{"title":"Ultrasound monitoring to detect embolic phenomena in the inferior vena cava during hip arthroplasty","authors":"","doi":"10.1016/j.redare.2024.04.017","DOIUrl":"10.1016/j.redare.2024.04.017","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p><span>Embolic phenomena frequently occur during hip joint replacement surgery, and may lead to haemodynamic instability in frail patients. Transoesophageal ultrasound monitoring is rarely available in non-cardiac operating theatres, and cannot be performed in awake patients under </span>spinal anaesthesia<span><span>. The main objectives of this prospective exploratory study were to determine the feasibility of using an alternative ultrasound approach to monitor the inferior vena cava during </span>hip replacement surgery, and to determine the intra and interobserver reliability of the ultrasound findings.</span></p></div><div><h3>Method</h3><p><span>We conducted a prospective exploratory study in 20 patients undergoing cemented hip arthroplasty in the </span>supine position under spinal anaesthesia and sedation. The inferior vena cava was assessed through a subcostal window at 10 intraoperative time points, and the findings were rated on a qualitative embolism severity scale. The ultrasound images were evaluated by 2 independent observers.</p></div><div><h3>Results</h3><p>An adequate subcostal window was obtained in 90% of cases. Intra- and inter-observer reliability was high (kappa index >0.80, p < 0.001). Nearly all (95%) patients presented some degree of embolism, which was severe in 50% of cases.</p></div><div><h3>Conclusions</h3><p>Our study suggests that ultrasound assessment of embolic phenomena in the inferior vena cava through a subcostal window is feasible in 90% of cases. The qualitative embolic severity rating scale is highly reproducible and has high intra- and inter-observer reliability.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859453","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

NRFit connectors in regional anaesthesia: avoiding medication errors 区域麻醉中的 NRFit 连接器：避免用药错误。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.04.012

引用次数: 0

Sarcopenia measured by tomography as a predictor of morbidity and mortality in thoracic surgery, a retrospective cohort study 通过断层扫描测量的 "肌肉疏松症 "可预测胸外科手术的发病率和死亡率。一项回顾性队列研究。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.05.001

{"title":"Sarcopenia measured by tomography as a predictor of morbidity and mortality in thoracic surgery, a retrospective cohort study","authors":"","doi":"10.1016/j.redare.2024.05.001","DOIUrl":"10.1016/j.redare.2024.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Sarcopenia<span><span> has been identified as a risk factor for perioperative adverse events. Several studies have shown that tomographic assessment of muscle mass can be an appropriate indicator of sarcopenia associated with morbidity and mortality. The aim of the study was to determine the association between height-adjusted area of the pectoral and erector spinae muscles (haPMA and haESA) and perioperative morbidity and mortality in </span>thoracic surgery.</span></p></div><div><h3>Methods</h3><p><span>Retrospective cohort study. Measurement of muscle areas was performed by </span>tomography<span>. The outcomes were 30-day mortality and postoperative morbidity. The discriminative capacity of the muscle areas was evaluated with an analysis of ROC curves and the Youden index was used to establish a cut-off point. The raw morbidity and mortality risk was determined and adjusted for potential confounders.</span></p></div><div><h3>Results</h3><p>A total of 509 patients taken to thoracic surgery were included. The incidence of 30-day mortality was 7.3%. An association was found between muscle areas and 30-day mortality and pneumonia, with adequate discriminative power for mortality (AUC 0.68 for haPMA and 0.67 for haESA). An haPMA less than 10 and haESA less than 8.5 cm<sup>2</sup>/m<sup>2</sup> were identified as a risk factor for 30-day mortality with an adjusted OR of 2.34 (95%CI 1.03–5.15) and 2.22 (95%CI 1.10–6.04) respectively.</p></div><div><h3>Conclusions</h3><p>Sarcopenia, defined as low muscle area in the pectoral and erector spinae muscles, is associated with increased morbidity and mortality in patients undergoing thoracic surgery.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892988","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

Postoperative hypotension: Is intraoperative use of dexmedetomidine safe in frail patients? 术后低血压：术中使用右美托咪定对体弱患者安全吗？

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 Epub Date: 2024-05-14 DOI: 10.1016/j.redare.2024.05.002

D Lopez-Lopez, R Mato-Bua, P Neira-Somoza, E Turrado-Blanco

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Chest compressions as a rescue manoeuvre to maintain aortic valve opening during left ventricular distention syndrome on venoarterial ECMO 在静脉-动脉 ECMO 患者出现左心室扩张综合征时，将胸外按压作为维持主动脉瓣开放的抢救手段。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.02.028

引用次数: 0

Uric acid and acute kidney injury in high-risk patients for developing acute kidney injury undergoing cardiac surgery: A prospective multicenter study 接受心脏手术的急性肾损伤高危患者的尿酸和急性肾损伤：一项前瞻性多中心研究。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.04.019

{"title":"Uric acid and acute kidney injury in high-risk patients for developing acute kidney injury undergoing cardiac surgery: A prospective multicenter study","authors":"","doi":"10.1016/j.redare.2024.04.019","DOIUrl":"10.1016/j.redare.2024.04.019","url":null,"abstract":"<div><h3>Purpose</h3><p>It is unclear whether preoperative serum uric acid (SUA) elevation may play a role in the development of acute kidney injury (AKI) associated with cardiac surgery (CSA-AKI). We conducted a cohort study to evaluate the influence of preoperative hyperuricemia on AKI in patients at high risk for developing SC-AKI.</p></div><div><h3>Design</h3><p>Multicenter prospective international cohort study.</p></div><div><h3>Setting</h3><p>Fourteen university hospitals in Spain and the United Kingdom.</p></div><div><h3>Participants</h3><p>We studied 261 consecutive patients at high risk of developing CSA-AKI, according to a Cleveland score ≥ 4 points, from July to December 2017.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Measurements and main results</h3><p>AKIN criteria were used for the definition of AKI. Multivariable logistic regression models and propensity score-matched pairwise analysis were used to determine the adjusted association between preoperative hyperuricemia (≥7 mg/dL) and AKI. Elevated preoperative AUS (≥7 mg/dL) was present in 190 patients (72.8%), whereas CSA-AKI occurred in 145 patients (55.5%). In multivariable logistic regression models, hyperuricemia was not associated with a significantly increased risk of AKI (adjusted Odds Ratio [OR]: 1.58; 95% confidence interval [CI]: 0.81–3; <em>P</em> = .17). In propensity score-matched analysis of 140 patients, the hyperuricemia group experienced similar adjusted odds of AKI (OR 1.05, 95%CI 0.93–1.19, <em>P</em> = .37).</p></div><div><h3>Conclusions</h3><p>Hyperuricemia was not associated with an increased risk of AKI in this cohort of patients undergoing cardiac surgery at high risk of developing CSA-AKI.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2341192924000945/pdfft?md5=9a8b8e2737e1d6073f070e2026e306ad&pid=1-s2.0-S2341192924000945-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873679","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

Postoperative hypotension: Is intraoperative use of dexmedetomidine safe in frail patients? 术后低血压：术中使用右美托咪定对体弱患者安全吗？

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.05.002

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 : 2024-07-08 DOI: 10.1016/j.redare.2024.07.001

S C Serafini, S N T Hemmes, A Serpa Neto, M J Schultz, E Tschernko, M Gama de Abreu, G Mazzinari, L Ball

{"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":"S C Serafini, S N T Hemmes, A Serpa Neto, M J Schultz, E Tschernko, M Gama de Abreu, G Mazzinari, L Ball","doi":"10.1016/j.redare.2024.07.001","DOIUrl":"10.1016/j.redare.2024.07.001","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods and analysis: </strong>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.</p><p><strong>Ethics and dissemination: </strong>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.</p><p><strong>Registration: </strong>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.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Radiofrequency of suprascapular nerve as an analgesic strategy for chronic pain management. Systematic review and meta-analysis. 肩胛上神经射频治疗作为慢性疼痛治疗的一种镇痛策略。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-07-08 DOI: 10.1016/j.redare.2024.07.006

J Sebastián Infante, N Blackburn, J Felipe Vargas

{"title":"Radiofrequency of suprascapular nerve as an analgesic strategy for chronic pain management. Systematic review and meta-analysis.","authors":"J Sebastián Infante, N Blackburn, J Felipe Vargas","doi":"10.1016/j.redare.2024.07.006","DOIUrl":"10.1016/j.redare.2024.07.006","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic shoulder pain is highly prevalent in the general population. Many different analgesic strategies have been described, including radiofrequency treatment to the suprascapular nerve (RFS); however, the effectiveness this approach remains unclear, and no strong recommendation can be made. The aim of this systematic review is to analyse the latest clinical trials evaluating the effectiveness of RFS techniques applied to the suprascapular nerve in terms of management of chronic shoulder pain, post-procedural functionality, and adverse effects.</p><p><strong>Methods: </strong>We performed a systematic review of clinical trials retrieved from Medline, Embase and the CENTRAL databases. We included trials comparing RFS with other strategies, including placebo, that had as their primary outcome measures pain rated on a visual analogue scale, functionality rated on a shoulder pain and disability index (SPADI), and the incidence of adverse events. Risk of bias was analysed using the Cochrane RoB2 tool. Evidence was analysed using a random effects model and heterogeneity was quantified using the I<sup>2</sup> test.</p><p><strong>Results: </strong>We identified 3030 trials, of which 8 met the inclusion criteria (n = 408). Seven had a high risk of bias. Pain intensity at 1 and 3 months was lower in patients receiving RFS, with a standardised mean difference (SMD) of -0.9 (95% CI [-1.1, 0.33], p = 0.29; I<sup>2</sup> 88%, p < 0.001) and -1.17 (95% CI [-2.49, 0.14], p = 0.08; I<sup>2</sup> 97%, p < 0.001), respectively. Functional compromise at 1 and 3 months decreased in patients receiving RFS, with an SMD of -0.31 (95% CI [-0.91, 0.29], p = 0.31; I<sup>2</sup> 80%, p < 0.001) and -1.54 (95% CI [-3.26, 0.19], p = 0.08; I<sup>2</sup> 98%, p < 0.001), respectively. No RFS-related adverse events were described.</p><p><strong>Conclusion: </strong>The evidence suggests that RFS reduces pain and improves functionality. However, the certainty of the evidence is low.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581966","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