Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Complications associated with delayed hip fracture surgery due to antiplatelet therapy","authors":"V. Moratalla Sasu,&nbsp;N. Bakhshaliyeva,&nbsp;J. Fernández González,&nbsp;E. Alday Muñoz","doi":"10.1016/j.redare.2025.501674","DOIUrl":"10.1016/j.redare.2025.501674","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Hip fractures typically affect elderly individuals with multiple comorbidities. Early surgical intervention within the first 48 hours has been shown to improve outcomes. However, when on antiplatelet therapy, surgery is often delayed preventing bleeding complications. This study aims to compare the incidence of perioperative complications, the need for blood transfusions, and the length of hospital stay between two groups of patients: those with delayed surgery more than 72 h due to antiplatelet use and those who had surgery within the first 48 h.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 110 patients who underwent hip fracture surgery between December 2012 and April 2018. Patients who had a delay of more than 72 h in the surgery were selected. A 1:1 randomized sampling was made to obtain a control group with surgery within the first 48 h.</div></div><div><h3>Results</h3><div>The baseline clinical characteristics were similar between the two groups, except for a higher rate of ischemic heart disease, cerebrovascular accidents and use of antiplatelet medication in the delayed surgery group. The early surgery group had a higher rate of acute renal failure (14.6% vs. 1.8%). The rest of the postoperative complications were higher in the delayed group (5.5% vs. 20%). The hospital stay was longer in the delayed group (15.2 vs. 8.93 days), although this difference accounted for the preoperative stay.</div></div><div><h3>Conclusion</h3><div>This study found that delayed surgery was linked to a higher incidence of medical complications and a longer hospital stay due to the wait time for surgery.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501674"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426892","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":"Why go blind if you can see the airway?","authors":"A.A.J. Van Zundert ,&nbsp;M.Á. Gómez-Ríos ,&nbsp;T.C.R.V. Van Zundert","doi":"10.1016/j.redare.2025.501688","DOIUrl":"10.1016/j.redare.2025.501688","url":null,"abstract":"<div><div>Airway management is a critical aspect of anesthesiology, essential for ensuring patient safety during various medical interventions, including surgery, emergency care, and critical care settings. Despite advancements, difficult laryngoscopy and tracheal intubation remain significant challenges, particularly in emergency scenarios, posing risks of hypoxia, brain damage, and death. This article examines the efficacy of videolaryngoscopy (VLS) and video laryngeal mask airways (VLMA) in improving airway management outcomes compared to traditional techniques across diverse clinical environments.</div><div>We conducted a comprehensive review of literature and current practices, analyzing the advantages and limitations of VLS and VLMA. The paper highlights the importance of visualization in airway management and evaluates the effectiveness of these devices in various settings. VLS and VLMA offer several benefits over traditional direct laryngoscopy, including enhanced glottic visualization, higher first-attempt success rates, reduced rates of oxygen desaturation, and fewer adverse events. These devices provide a larger angle of view and allow for real-time monitoring, improving overall patient safety. Additionally, they serve as excellent educational tools for training anesthesiologists and other healthcare providers involved in airway management.</div><div>In emergency and critical care scenarios, the rapid and accurate placement of airway devices is crucial. VLS and VLMA facilitate quicker and more reliable intubation, reducing the likelihood of complications such as esophageal intubation or airway trauma. These technologies also allow for better teamwork and coordination as the airway view can be shared with the entire medical team.</div><div>The adoption of VLS and VLMA as standard practice in airway management can significantly enhance visualization and success rates, reducing the risk of complications. These devices should be integrated into routine clinical use to improve patient outcomes. Further research is warranted to optimize their application and explore advancements such as artificial intelligence in airway management.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501688"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426894","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":"Anaesthesia evaluation and perioperative strategies in liver disease patients with cardiohepatic syndrome.","authors":"Á Espinosa, J Ripolles Melchor, M Jain, R Navarro-Perez, Y A Shadad, A Malvido, A Abad Gurumeta, R Alharbi","doi":"10.1016/j.redare.2025.501735","DOIUrl":"10.1016/j.redare.2025.501735","url":null,"abstract":"<p><p>Cardiohepatic syndrome (CHS) presents a significant challenge in perioperative management due to the complex interaction between liver and heart dysfunction. CHS, analogous to cardiorenal syndrome, encompasses various conditions where hepatic and cardiovascular pathologies exacerbate one another. Patients with chronic liver disease, cirrhosis, or heart failure often exhibit increased perioperative morbidity and mortality, necessitating tailored anesthetic strategies. A comprehensive understanding of CHS pathophysiology is crucial, as it informs risk assessment and guides perioperative management. Risk stratification tools such as the Child-Pugh and MELD scores are commonly used, but they have limitations in fully capturing perioperative risks. The updated STS 2024 model includes liver-specific parameters, improving risk prediction in cardiac surgeries. Additionally, the VOCAL-Penn score addresses gaps in traditional risk models, providing a more accurate assessment for patients with advanced liver disease. Perioperative management focuses on minimizing hemodynamic stress and avoiding drugs metabolized by the liver. Agents like Remifentanil, Atracurium, and Esmolol are preferred for their minimal hepatic metabolism. Vasopressors such as terlipressin and vasopressin, which target the splanchnic circulation, improve hemodynamics in these patients. Within the Enhanced Recovery After Surgery (ERAS) framework, optimizing nutrition and fluid management is essential for reducing perioperative complications. Effective management of patients with CHS requires a multidisciplinary approach that integrates comprehensive risk assessment and individualized anesthetic strategies. This approach improves outcomes by reducing perioperative complications and mortality in this high-risk population.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501735"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733629","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":"Efficacy of combining ultrasound-guided spermatic cord block with ilioinguinal nerve block for analgesia in pediatric inguinal herniotomy: A randomized controlled study.","authors":"E M Elemam, I Abdelbaser, K Elbahrawy, M M Alseoudy, S El Kenany","doi":"10.1016/j.redare.2025.501675","DOIUrl":"10.1016/j.redare.2025.501675","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>US-guided ilioinguinal nerve block (IINB) is a common analgesic regional technique in pediatric inguinal herniotomy, However, alone it could not provide complete analgesia for such surgery due to spare of the genital branch of the genitofemoral nerve (GFN) and some sympathetic fibers. Spermatic cord block (SCB) can block both of them. This study aimed to assess the analgesic effects of combining US-guided spermatic SCB and IINB in pediatric patients subjected to elective open inguinal herniotomies.</p><p><strong>Patients and methods: </strong>A total of 50 male pediatric patients who underwent inguinal herniotomy were included in the current prospective, randomized, controlled study. Patients were randomly allocated to two groups: one group received IINB and the other received combined IINB and SCB. The number of patients who required rescue analgesia after surgery was the primary outcome parameter, whereas assessment of the intraoperative hemodynamic parameters (MAP: mean arterial pressure; HR: heart rate), total consumption of paracetamol, postoperative pain score, and occurrence of adverse events were the secondary outcome measures.</p><p><strong>Results: </strong>The number of patients who needed rescue analgesia was significantly lower in IINB/SCB group (12%), than IINB group (41 %), P = 0.025. The median (interquartile range) total dose of paracetamol consumption was significantly lower in the IINB/SCB group [0 (0-0)] mg/kg than in the IINB group [0 (0-10)], P = 0.020. Pain score was significantly (P < 0.05) lower in the IINB/SCB group than in the IINB group at all-time points. Both MAP and HR were significantly higher in the IINB group than in the IINB/SCB group during traction on hernial sac, P < 0.05. Occurrence of adverse events was comparable in both groups.</p><p><strong>Conclusions: </strong>Adding SCB to IINB can provide better quality of postoperative analgesia and more stable intraoperative hemodynamics in pediatric patients undergoing inguinal hernia repair.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501675"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695031","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":"Tracheal intubation with videolaryngoscopy: Bridging the language gap.","authors":"M A Fernández-Vaquero, A A J van Zundert, M A Gómez-Ríos","doi":"10.1016/j.redare.2025.501676","DOIUrl":"10.1016/j.redare.2025.501676","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501676"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695033","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":"Tracheal rupture resulting from superinfected aortic intramural hematoma in ascending aortic prosthesis.","authors":"E Pereda González, A Cervera Puchades, M J Hernández-Cádiz, J Moreno Pachón, J de Andrés Ibáñez","doi":"10.1016/j.redare.2025.101646","DOIUrl":"10.1016/j.redare.2025.101646","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"101646"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695034","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":"Application of generative artificial intelligence chatbots in the field of anesthesia.","authors":"A Barroso, R Casans","doi":"10.1016/j.redare.2025.501667","DOIUrl":"10.1016/j.redare.2025.501667","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501667"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695028","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":"Effect of caffeine on respiratory rate, recovery time, and brain wave activity during emergence from sevoflurane anaesthesia in rats.","authors":"B M Çam, H Topçu, E S Tiryaki, G Arslan","doi":"10.1016/j.redare.2025.501730","DOIUrl":"10.1016/j.redare.2025.501730","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether caffeine affects the respiratory rate, recovery time, and brain slow-wave (theta and delta) activity during emergence from sevoflurane anaesthesia in rats.</p><p><strong>Methods: </strong>Male Sprague-Dawley rats (n = 16) were randomly divided into two groups: control (saline) and caffeine (75 mg/kg). After tripolar electrode implantation, rats were placed in an anaesthesia induction chamber and brain electrocorticographic wave activity was recorded. Anaesthesia was induced with 4% sevoflurane (4 L/min O2) for 5 min, and once all the rats were asleep, sevoflurane concentration was reduced to 3% (4 L/min O2) for anaesthesia maintenance. Saline or caffeine was injected intraperitoneally 10 min before discontinuing anaesthesia. After sevoflurane was stopped, the rats were removed from the chamber, and the respiratory rate, tail clamp response, and the righting reflex (full emergence) were observed and noted. The frequency and amplitude of theta and delta waves (from baseline) and the frequency of theta oscillations were calculated from ECoG recordings.</p><p><strong>Results: </strong>Caffeine administration increased the respiratory rate during sevoflurane anaesthesia; however, no significant difference vs controls was observed during full emergence. The time to tail clamp response and righting reflex, theta oscillations, and the frequency and amplitude of slow waves decreased with caffeine.</p><p><strong>Conclusions: </strong>Acute administration of caffeine accelerates the emergence from sevoflurane anaesthesia by affecting the central nervous system. There is evidence that prolonged emergence from anaesthesia increases postoperative delirium, therefore intraoperative caffeine may reduce this risk.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501730"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695029","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":"Perioperative anesthetic management and postoperative outcomes of patients treated with CyberKnife® robotic radiosurgery","authors":"D. Gallego González ,&nbsp;S. Ramírez Pulgarín ,&nbsp;K. Marisancén Carrasquilla ,&nbsp;Y.A. Colina Vargas ,&nbsp;C. Vera Marín ,&nbsp;L.F. Botero Posada","doi":"10.1016/j.redare.2024.501652","DOIUrl":"10.1016/j.redare.2024.501652","url":null,"abstract":"<div><h3>Background and objective</h3><div>The CyberKnife<strong>®</strong> is a robotic stereotactic radiosurgery system designed for non-invasive treatment of tumor lesions. Some of these procedures are performed under sedation or general anesthesia, depending on the patient and the lesion being treated. The objective of this study is to describe the anesthetic management and postoperative outcomes of patients treated with CyberKnife<strong>®</strong> radiosurgery at a reference center for neurosurgery in the city of Medellín, Colombia.</div></div><div><h3>Methods</h3><div>A descriptive, retrospective study was conducted on patients treated with CyberKnife<strong>®</strong> under sedation or general anesthesia between 2012 and 2022.</div></div><div><h3>Results</h3><div>75 patients were included, 56% of whom were female, with a median age of 59 years, primarily operated on for uveal melanomas (40%) and other tumor pathologies of the central nervous system; most frequently scheduled for a total of 5 radiosurgery sessions (66,7%), on an outpatient basis in 96% of cases. The main anesthetic technique used was balanced general anesthesia (76%) with sevoflurane, propofol, lidocaine, fentanyl. Neuromuscular relaxation was used in 58,7% of patients. Airway management was performed with a laryngeal mask in most cases (64%). The main minor side effects or complications identified were postoperative headache (22,7%), followed by intraoperative hypotension (18,7%) and bradycardia (16%). No major complications associated with anesthetic management were reported.</div></div><div><h3>Conclusions</h3><div>Balanced general anesthesia with neuromuscular relaxation was the main anesthetic technique used for CyberKnife® radiosurgery. Despite the logistical difficulties in this type of procedure, no major complications during the perioperative period were found.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 501652"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857492","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":"Inorganic phosphorus as a predictor of postoperative low cardiac output syndrome in congenital heart disease surgery","authors":"M.A. Murillo-Pozo ,&nbsp;A.M. Vázquez-Florido ,&nbsp;A. Ortiz-Alvarez ,&nbsp;V. Modesto i Alapont ,&nbsp;A. González-Calle ,&nbsp;E. Sánchez-Valderrábanos","doi":"10.1016/j.redare.2025.501654","DOIUrl":"10.1016/j.redare.2025.501654","url":null,"abstract":"<div><h3>Background and objective</h3><div>Low cardiac output syndrome (LCOS) is the most common complication after cardiac surgery in children with congenital heart disease (CHD). The aim of this study was to assess the predictive value of serum inorganic phosphorus (SIPL) as an indicator of LCOS in the postoperative period.</div></div><div><h3>Materials and methods</h3><div>From June 2018 to December 2019, a single-center prospective study was conducted in patients with CHD undergoing surgery who required extracorporeal circulation (ECC). In the postoperative period, patients were divided into group 1 with LCOS and group 2 without LCOS. Blood samples were extracted in pre and postoperative periods. Serial measurements of SIPL, NT-proBNP, troponin T and creatinine were collected and compared between both groups. Multivariate analyses were conducted to identify the risk factors of SBGC.</div></div><div><h3>Results</h3><div>A total of 97 patients were included, with 31 in group 1 and 66 in group 2. There was an increment of SIPL which peaked at the 8-h postsurgery (5.3 mg/dL, 4.6–5.8). Postoperative median SIPL in the group 1 were significantly higher than in the group 2. All consecutive SIPL measurements also were significantly higher in group 1. Changes in SIPL over time approached statistical significance (<em>p</em> &lt; 0.001). Logistic regression analyses indicated that ECC (OR: 1.01; 95% CI: 0,9–1.01), SIPL (OR: 1.02; 95% CI: 1–1.04), NT-ProBNP (OR: 1; 95% CI; 1–1.0) were the independent risk factors of LCOS.</div></div><div><h3>Conclusions</h3><div>The increase in SIPL was more pronounced in LCOS group 1. SIPL emerged as a new predictive risk factors of LCOS.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 501654"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026230","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}