Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Management of preoperative anaemia in colorectal cancer and analysis of perioperative Patient Blood Management programs","authors":"A. Bernardo Chávez,&nbsp;N. Bakhshaliyeva,&nbsp;A. Planas Roca,&nbsp;E. Alday Muñoz","doi":"10.1016/j.redare.2026.502174","DOIUrl":"10.1016/j.redare.2026.502174","url":null,"abstract":"<div><h3>Introduction and endpoints</h3><div>Preoperative anaemia is a common finding in patients with colorectal cancer (CRC) and is significantly associated with morbidity and mortality. Patient Blood Management Programs (PBM), have been developed to improve patient outcomes. This study aimed to evaluate the effectiveness of the Outpatient Blood Management Program (OBMP) in a tertiary hospital in Spain. The primary endpoint was to determine the percentage of patients who recover from anaemia after treatment at the OBMP. Additionally, correlations between preoperative anaemia, administered treatments, and surgical waiting times were analyzed.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted including 537 patients who underwent surgical intervention for CRC. Demographic data, haemoglobin values at three time points (inclusion on the surgical waiting list, preoperative, and postoperative), as well as the time intervals between inclusion on the waiting list and the performance of surgery, were collected.</div></div><div><h3>Results</h3><div>The prevalence of anaemia was 43.3% at the time of inclusion on the surgical waiting list. Of the total anaemic patients, 42% received specific treatment. Treatment at the OBMP was associated with a higher recovery rate (37%) and a more significant increase in haemoglobin (1.35 g/dl IC95% (0.7−2.1) vs 0.4 IC95% (0–1.6) g/dl )). Preoperative anaemia was associated with longer surgical waiting times, higher incidence of transfusions, higher prevalence of postoperative anaemia, and prolonged hospital stays.</div></div><div><h3>Conclusion</h3><div>The OBMP offers an opportunity to improve the management of anaemia in patients undergoing surgery for colorectal cancer (CRC); however, it requires interdisciplinary coordination to minimize its impact on surgical waiting times.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 7","pages":"Article 502174"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383448","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":"Enhanced recovery after surgery programs in perioperative medicine: From implementation to intelligent, data-driven care","authors":"J.M. Ramírez,&nbsp;O. Ljungqvist","doi":"10.1016/j.redare.2026.502173","DOIUrl":"10.1016/j.redare.2026.502173","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 7","pages":"Article 502173"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407645","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":"Retraction notice to : Erector spine plane block versus local infiltration anaesthesia for transforaminal percutaneous endoscopic discectomy: Prospective randomise controlled trial Volume 70, Issue 10, December 2023, Pages 552-560","authors":"M. Barsa,&nbsp;O. Filyk","doi":"10.1016/j.redare.2026.502200","DOIUrl":"10.1016/j.redare.2026.502200","url":null,"abstract":"<div><div>This article has been retracted: please see Elsevier Policy on Article Withdrawal (<span><span>https://www.elsevier.com/about/policies/article-withdrawal</span><svg><path></path></svg></span>).</div><div>This article has been retracted due to non-compliance with the journal's clinical trial registration policy. In accordance with international editorial standards, clinical trials must be prospectively registered in a public database before enrollment of the first participant. Although the study received Ethics Committee approval, the trial registration was completed after data collection had finished. This retraction is based solely on regulatory and editorial policy requirements and does not reflect concerns regarding the scientific or ethical quality of the research.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 7","pages":"Article 502200"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650040","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}

{"title":"Endotracheal tube–esophageal stent interaction in tracheoesophageal fistula: A rare complication","authors":"I. Durmus,&nbsp;M. Bulun Yediyildiz","doi":"10.1016/j.redare.2026.502036","DOIUrl":"10.1016/j.redare.2026.502036","url":null,"abstract":"<div><div>Tracheoesophageal fistula (TEF) is a life-threatening complication that may develop following prolonged intubation. Consequently, the importance of early diagnosis and intervention cannot be overstated. In the presence of TEF, orotracheal intubation (OTI) must be performed with the utmost caution. In patients with post-intubation respiratory failure or gastric distension, it is important to consider the risk of the endotracheal tube (ETT) penetrating the esophagus through the TEF.</div><div>We describe the case of a 57-year-old female patient with a history of prolonged intubation. The ETT entered the esophagus through the TEF and abutted an esophageal stent that had been placed after the TEF diagnosis, resulting in respiratory failure. The patient improved following endoscopic evaluation and intervention.</div><div>This case illustrates a rare complication that can occur during intubation in patients with TEF.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 7","pages":"Article 502036"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213770","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":"Intraoperative haemodynamic support intensity as a marker of perioperative complexity and hospital resource utilization in noncardiac surgery","authors":"A. Guevara-Tirado","doi":"10.1016/j.redare.2026.502164","DOIUrl":"10.1016/j.redare.2026.502164","url":null,"abstract":"<div><h3>Introduction</h3><div>The intensity of intraoperative hemodynamic support may reflect perioperative physiological complexity and be associated with increased hospital resource utilization.</div></div><div><h3>Objective</h3><div>To evaluate the use of intraoperative hemodynamic support and the intensity of such support as markers of perioperative complexity and hospital resource utilization.</div></div><div><h3>Materials and methods</h3><div>Analytical study using a secondary database with perioperative information from patients undergoing noncardiac surgery (<em>n</em> = 6246). The main exposure was intraoperative hemodynamic support, analysed both dichotomously and through a continuous index of intraoperative hemodynamic support intensity. Outcomes included admission to the intensive care unit (ICU) and hospital length of stay. Multivariable logistic and negative binomial regression models were used, adjusted for relevant clinical and surgical variables, including interaction analyses.</div></div><div><h3>Results</h3><div>Intraoperative hemodynamic support was not independently associated with ICU admission (OR 1.09; 95% CI: 0.93–1.28). In contrast, ASA score (OR 2.89 per point), surgical duration, age, and emergency surgery showed significant associations. Intraoperative hemodynamic support was associated with a longer hospital length of stay (IRR 1.06; 95% CI: 1.02–1.09), an effect that was more pronounced in prolonged procedures. The continuous index of intraoperative hemodynamic support intensity showed a strong association with longer hospital stays (IRR 1.37; 95% CI: 1.34–1.40).</div></div><div><h3>Conclusions</h3><div>Greater intraoperative hemodynamic support intensity was associated with longer hospital length of stay, particularly in prolonged surgeries, serving as a marker of perioperative complexity and hospital resource utilization.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 7","pages":"Article 502164"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274144","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":"Therapeutic monitoring of beta-lactams in critically ill patients with sepsis: Clinical trial protocol","authors":"I. Varela-Rey,&nbsp;S.M. Díaz-Prado,&nbsp;M.Á. Gómez-Ríos","doi":"10.1016/j.redare.2026.502165","DOIUrl":"10.1016/j.redare.2026.502165","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a leading cause of morbidity and mortality among hospitalized patients and is associated with intensive use of β-lactam antibiotics. These drugs show time-dependent pharmacodynamics and high pharmacokinetic variability in this population, making it difficult to achieve therapeutic levels. Therapeutic drug monitoring (TDM) may optimise dosing, but its routine clinical implementation remains limited.</div></div><div><h3>Objective</h3><div>To evaluate whether individualized β-lactam dosing guided by TDM reduces time to full clinical recovery compared with standard dosing in hospitalized patients with sepsis (ICU and ward).</div></div><div><h3>Methods</h3><div>OPTIBETA is a pragmatic, randomized, controlled, open-label clinical trial with blinded outcome assessment to be conducted at a tertiary hospital in Spain. Adult patients (≥18 years) admitted to the intensive care unit or infectious diseases ward with sepsis will be included. Participants will be randomized 1:1 to either a TDM-guided dosing arm (dose adjustments according to PK/PD targets) or a standard dosing arm. Clinical, microbiological, and pharmacological outcomes will be collected. The primary endpoint is time to complete clinical cure. Secondary outcomes include overall survival, microbiological cure, ICU and hospital length of stay, adverse events, and achievement of PK/PD targets. The estimated sample size is 198 patients.</div></div><div><h3>Expected results</h3><div>We hypothesize that TDM-guided dosing will reduce time to clinical cure, improve overall outcomes, and decrease adverse events compared with standard dosing.</div></div><div><h3>Conclusions</h3><div>OPTIBETA will provide high-quality evidence on the role of β-lactam TDM in hospitalized patients with sepsis and may support its inclusion in antimicrobial stewardship programs.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 7","pages":"Article 502165"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274135","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":"Investigation of dye spread following ultrasound guided injection at the femoral nerve, proximal and distal adductor canal – A cadaver study","authors":"S. Diwan,&nbsp;P. Mane,&nbsp;A. Gupta,&nbsp;T.S. Gugapriya,&nbsp;P.R. Jadhao,&nbsp;B. Balasubramanian","doi":"10.1016/j.redare.2026.502162","DOIUrl":"10.1016/j.redare.2026.502162","url":null,"abstract":"<div><h3>Background</h3><div>Total knee arthroplasty (TKA) is associated with significant postoperative pain. Regional analgesic techniques targeting femoral nerve (FN) and adductor canal (AC) are commonly employed; however, uncertainty persists regarding optimal injection site within the AC. Cadaveric investigations provide anatomical insights into injectate spread patterns, but their interpretation requires caution when extrapolating to clinical practice.</div></div><div><h3>Methods</h3><div>Twelve thighs from six embalmed human cadavers underwent ultrasound-guided injections of different-colored dyes, with equal volumes administered at three predefined locations: FN, proximal AC, and distal AC. Subsequent anatomical dissections were performed to assess nerve staining patterns. Injection sites and volumes were standardized to allow for comparative anatomical evaluation.</div></div><div><h3>Results</h3><div>Femoral-level injections stained the femoral nerve and its major branches. Proximal AC injections consistently stained both the saphenous nerve and nerve to vastus medialis, whereas distal canal injections predominantly stained the saphenous nerve with only variable distal obturator involvement. The vaso-adductor membrane stained consistently after proximal canal injection. No sciatic nerve staining was observed.</div></div><div><h3>Conclusion</h3><div>Equal-volume dye injections at the FN, proximal AC, and distal AC demonstrate distinct patterns of neural staining. Proximal AC injections resulted in consistent staining of both SN and NVM, whereas distal injections predominantly involved SN. These findings provide anatomical relevance regarding adductor canal block techniques but do not imply clinical superiority of any technique. Clinical correlation is required before extrapolating these observations to clinical practice.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 7","pages":"Article 502162"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240940","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":"Early ultrasound-guided thoracic paravertebral block reduces postherpetic neuralgia and improves functional outcomes in acute herpes zoster: A randomized clinical trial","authors":"A.O. Mahmoud Abdallah,&nbsp;M.M. Abdelrady,&nbsp;H. Omar Mahmoud,&nbsp;M.A. Mohamed Hasan Eisa","doi":"10.1016/j.redare.2026.502176","DOIUrl":"10.1016/j.redare.2026.502176","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Acute herpes zoster is associated with severe neuropathic pain and a high risk of developing postherpetic neuralgia (PHN), which significantly impairs quality of life and functional status. Ultrasound-guided thoracic paravertebral block (TPVB) has emerged as a promising regional analgesic technique for managing acute herpes zoster pain and potentially preventing PHN. This study aimed to evaluate the efficacy of ultrasound-guided TPVB with local anaesthetic and corticosteroid in reducing pain intensity, improving functional and quality-of-life outcomes, and decreasing the incidence of PHN.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this prospective, randomized, controlled clinical trial, 100 patients with acute thoracic herpes zoster (rash duration ≤14 days, Numerical Rating Scale [NRS] ≥4) were randomly assigned to either a control group receiving standard medical therapy or an intervention group receiving standard therapy plus ultrasound-guided TPVB using 0.25% bupivacaine and 40 mg methylprednisolone. The block was performed at 48 -h intervals for three sessions. The primary outcome was PHN at 90 days (3 meses). Six-month incidence was evaluated as a secondary outcome. Secondary outcomes included pain intensity (NRS), quality of life assessed by the Short Form-36 (SF-36), sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI), functional disability assessed by the Pain Disability Index (PDI), neuropathic pain assessed by the Douleur Neuropathique 4 (DN4) questionnaire, rescue analgesic consumption, sensory examination findings, patient satisfaction, and adverse events.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Patients in the TPVB group demonstrated significantly lower pain scores compared with the control group at all follow-up time points from 48 horas to 6 meses (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). The incidence of PHN at 90 days was significantly reduced in the TPVB group compared with the control group (16% vs. 34%, &lt;em&gt;P&lt;/em&gt; = 0.037). The TPVB group also showed significant improvements in quality of life (SF-36), sleep quality (PSQI), and functional disability (PDI) at 3 and 6 meses (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). Neuropathic pain scores (DN4) were significantly lower at 1, 3, and 6 meses, and rescue analgesic consumption was significantly reduced during the first month of follow-up (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). Patient satisfaction scores were significantly higher in the TPVB group (&lt;em&gt;P&lt;/em&gt; = 0.033). No serious block-related complications were observed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Early ultrasound-guided thoracic paravertebral block using local anaesthetic and corticosteroid is an effective and safe adjunctive therapy for acute thoracic herpes zoster. This intervention provides superior pain control, significantly reduces the incidence of postherpetic neuralgia, and improves functional status, sleep quality, and overall quality of life. These findings support the use of early TPVB as part of multimodal pain manage","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 7","pages":"Article 502176"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427634","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":"Viscoelastic testing: an essential tool for an efficient health system","authors":"S.M. Veiras del Río,&nbsp;on behalf of the Perspectiva Multidisciplinar sobre el Uso de Tests Viscoelásticos en la Práctica Clínica, partes I y II document writing group","doi":"10.1016/j.redare.2026.502047","DOIUrl":"10.1016/j.redare.2026.502047","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 7","pages":"Article 502047"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274179","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":"Awake orotracheal intubation using the C-MAC D-Blade in cancer patients with predicted difficult airway: A single-center experience","authors":"D. Abdellatif Elebedy,&nbsp;A. Medhat Mohasseb,&nbsp;E. Mohamed Mokbel,&nbsp;M. Mohammed Alseoudy","doi":"10.1016/j.redare.2026.502130","DOIUrl":"10.1016/j.redare.2026.502130","url":null,"abstract":"<div><h3>Background and aims</h3><div>Managing difficult airways in cancer patients remains a significant challenge for anesthetists worldwide due to the risk of serious complications. Therefore, this study aimed to evaluate the feasibility of awake orotracheal intubation using the C-MAC D-Blade in cancer patients with predicted difficult airways undergoing elective surgery under general anesthesia.</div></div><div><h3>Method</h3><div>We enrolled 180 cancer patients with difficult airways, as assessed by the El-Ganzouri Risk Index. Awake orotracheal intubation was performed using the C-MAC D-Blade, with topical local anesthesia and sedation. The primary outcome was the first-attempt intubation success rate. Secondary outcomes included the total intubation time, hemodynamic changes, patient responses, complications, and the ease of the procedure, assessed by both anesthesiologists and patients using a visual analog scale (VAS).</div></div><div><h3>Results</h3><div>First-attempt intubation was successful in 89.4% of patients (n = 161), 8.3% (n = 15) required a second attempt, and 2.2% (n = 4) required a third attempt. No failed intubations were recorded. The mean intubation time with its standard deviation was 40.8 ± 9.01 s. At one and two minutes after intubation, heart rate and mean arterial blood pressure increased significantly from baseline values (<em>P</em> &lt; .001). Tooth damage occurred in three patients, bleeding gums in seven patients, and tissue edema in four patients. The median VAS score for both anesthesiologists and patient satisfaction was 9, indicating high procedural feasibility. Additionally, a statistically significant positive correlation was observed between the number of intubation attempts and cough severity (<em>P</em> = .001).</div></div><div><h3>Conclusion</h3><div>Awake video-laryngoscopic intubation using the C-MAC D-Blade achieved a high first-attempt success rate (89.4%) with minimal complications in cancer patients with predicted difficult airways. These results suggest it is a safe and effective option when careful assessment, adequate topical anesthesia, and appropriate sedation are ensured, although comparative studies are needed to better define its role.</div></div><div><h3>Clinical Trial Registry</h3><div>Registered at clinicaltrial.gov registry system (clinical trial identifier: PACTR202408730457046).</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 6","pages":"Article 502130"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059325","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}