Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Literature search for healthcare management decision-making on how to increase productivity by performing more surgical cases in the same staffed time","authors":"F. Dexter ,&nbsp;M.Á. Gómez-Ríos ,&nbsp;R.H. Epstein","doi":"10.1016/j.redare.2024.501656","DOIUrl":"10.1016/j.redare.2024.501656","url":null,"abstract":"<div><div>This report shows how the results of a literature search for studies on healthcare management decision-making can help anaesthesiologists improve operating room (OR) turnover. The Scopus database was searched to obtain relevant studies on increasing surgical case numbers. References and citations were then examined. The search identified strategies to reduce OR downtime time, facilitate overlapping surgeries, and optimize OR scheduling. Key findings show that reducing anaesthesia-controlled times alone is insufficient to reliably add extra surgical cases within an 8-hour workday. Instead, significant productivity gains are achieved by managing OR turnover times, using induction rooms, and revising workflows to maximize efficiency. Studies show that overlapping surgeries and strategic use of adjacent spaces can significantly increase the number of surgical cases performed daily. Most surgical growth is driven by accommodating low caseload surgeons across multiple specialties. Facilitating OR time access for these surgeons through flexible scheduling and re-sequencing of cases is crucial. Additionally, anaesthesiologists should be engaged in daily OR scheduling and case sequencing, particularly within 2 days of surgery. The dual goals are to increase OR utilization and reduce patient wait times. These results from the management case report underscores the importance of evidence-based OR management practices and proactive involvement of anaesthesiologists in scheduling decisions to enhance surgical productivity effectively.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501656"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857490","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":"History lessons for an uncertain future? Anaesthesiology and resuscitation during the Ifni-Sahara conflict (1957–1958)","authors":"R. Navarro-Suay ,&nbsp;L.E. Togores-Sánchez ,&nbsp;R. García-Cañas ,&nbsp;F. Gilsanz-Rodríguez","doi":"10.1016/j.redare.2024.101648","DOIUrl":"10.1016/j.redare.2024.101648","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 101648"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873722","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":"Clinical characteristics and prognostic implication of atrial fibrillation in the postoperative period of cardiac surgery with cardiopulmonary bypass","authors":"C.Y. Salinas-Ulloa ,&nbsp;R. Gopar-Nieto ,&nbsp;E. García-Cruz ,&nbsp;G. Rojas-Velasco ,&nbsp;D. Manzur-Sandoval","doi":"10.1016/j.redare.2025.501673","DOIUrl":"10.1016/j.redare.2025.501673","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the latest innovations in surgical and cardiopulmonary bypass techniques, atrial fibrillation remains a common occurrence in patients undergoing heart surgery, and has been shown to increase the incidence of intra- and postoperative complications. For this reason, it is among the top 10 research topics in cardiovascular surgery.</div></div><div><h3>Method</h3><div>Observational, analytical, retrospective study carried out at the largest cardiovascular centre in Mexico. Adult patients (&gt;18 years) with no history of atrial fibrillation who underwent on-pump heart surgery between 1 January 2022 and 31 December 2023 were included. Variables that have previously been correlated with postoperative atrial fibrillation (POAF) were evaluated.</div></div><div><h3>Results</h3><div>A total of 544 patients were included. The incidence of POAF was 23.8%. Overall in-hospital mortality was 5.9%. There was a significant difference in age between patients that developed postoperative atrial fibrillation and those that maintained sinus rhythm (62 years vs 57 years, <em>p</em> = &lt; 0.01). Using a univariate logistic regression model, we found that POAF significantly predicts the occurrence of hospital-acquired pneumonia (OR 3.12, 95% CI 1.61−6.02, <em>p</em> = &lt;0.01) and the requirement for renal replacement therapy (OR 3.04, 95% CI 1.34−6.86, <em>p</em> = &lt;0.01).</div></div><div><h3>Conclusions</h3><div>Atrial fibrillation is a common arrhythmia in the postoperative period of on-pump heart surgery, and is a predictor of adverse outcomes. Prevention, early detection and treatment of POAF may have prognostic implications.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501673"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426886","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":"Utility of optic nerve sheath ultrasound during laparoscopic colorectal surgery","authors":"L. Alcover Navarro ,&nbsp;C.S. Romero García ,&nbsp;E. Mateo Rodríguez ,&nbsp;P. Granero Castro ,&nbsp;J. De Andrés Ibáñez","doi":"10.1016/j.redare.2025.501672","DOIUrl":"10.1016/j.redare.2025.501672","url":null,"abstract":"<div><h3>Introduction</h3><div>Abdominal laparoscopic surgery to treat colorectal cancer has been shown to be more effective than open surgery in terms of mobility, hospital stay, tumour recurrence and long-term survival. This surgical approach requires pneumoperitoneum and the Trendelenburg position (35−45º), both of which have a negative effect on the cardiovascular system and can even change the cerebrovascular physiology, leading to an increase in intracranial pressure (ICP). Ultrasound measurement of optic nerve sheath (ONS) diameter has shown excellent correlation with invasive ICP measurement.</div></div><div><h3>Objective</h3><div>To correlate the increase in ONS diameter with surgical time and time to emergence after anaesthesia. The incidence of visual disturbances (visual acuity) and/or neurological complications (agitation, cognitive dysfunction) in the immediate postoperative period was also evaluated.</div></div><div><h3>Material and methods</h3><div>30 consecutive patients undergoing laparoscopic surgery for rectal or sigmoid adenocarcinoma were recruited. Pre-, intra- and postoperative ONS measurements were obtained and the Snellen test for visual acuity, Mini Mental Test for cognitive function, and the Richmond Agitation and Sedation Scale (RASS) were administered.</div></div><div><h3>Results</h3><div>ONS increased intraoperatively in both eyes compared to baseline. However, this was not correlated with total surgical time or time to emergence, and there was no statistically significant correlation between ONS and postoperative neurological or visual alterations.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501672"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426893","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":"Intrathecal catheter after accidental dural puncture in obstetric patients: Safety and effectiveness reducing post-dural puncture headache","authors":"Gerard Moreno Giménez,&nbsp;Martha Cristina Melo Cruz,&nbsp;Marta Ferrándiz Mach,&nbsp;Sergi Sabaté Tenas","doi":"10.1016/j.redare.2024.501671","DOIUrl":"10.1016/j.redare.2024.501671","url":null,"abstract":"<div><h3>Background</h3><div>Post-dural puncture headache (PDPH) after an accidental dural puncture (ADP) is a common complication in obstetric analgesia. It has been proposed that inserting an intrathecal catheter (ITC) after an ADP may reduce PDPH incidence and the need for therapeutic epidural blood patch (EBP). Our primary objective was to assess if the insertion of an ITC after an ADP reduces the incidence of PDPH in obstetric patients. Secondary objectives included evaluating EBP requirements and ITC-related complications.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of all obstetric patients with a documented ADP during their labour analgesia between January 2018 to December 2022. Data from the patients in whom an ITC was inserted and those with a repeated epidural were compared.</div></div><div><h3>Results</h3><div>Over our 5-year study period, 35 cases of ADP were documented. Of these, 16 patients (45.7%) received an ITC for 24 hours, while 19 (54.3%) underwent epidural re-siting. No significant difference was observed in PDPH incidence between ITC and re-sited epidural groups (62.5% vs 68.4%; RR 0.84; <em>P</em> = 0.713), nor in EBP requirement (18.8% vs 31.6%; RR 0.84; <em>P</em> = 0.387). Follow-up duration did not differ significantly between groups and no ITC-related complications were reported within 1 month.</div></div><div><h3>Conclusions</h3><div>Our findings align with previously reported literature, indicating a trend favoring ITC utilization. In addition to the potential benefit of reducing CPPD incidence, their use is safe and provides quality analgesia with rapid onset.</div></div><div><h3>IRB number</h3><div>IIBSP-CEF-2022-146.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 501671"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873769","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":"Erector spinae plane block for obstetric analgesia in a patient with factor XI deficiency: a case report","authors":"P. Martín Serrano ,&nbsp;A. Ferraz Pérez ,&nbsp;C. Medina Hernández ,&nbsp;V. Prieto Hidalgo","doi":"10.1016/j.redare.2024.101632","DOIUrl":"10.1016/j.redare.2024.101632","url":null,"abstract":"<div><div>Factor XI (FXI) deficiency is a rare bleeding disorder characterized by a quantitative or qualitative deficiency of FXI. The symptoms are highly variable, and the severity and site of bleeding is unpredictable and does not necessarily correlate with FXI levels. FXI deficiency is classified by phenotype: bleeding or non-bleeding, depending on the clinical manifestations.</div><div>We present the case of a woman in her twenties diagnosed with FXI with a bleeding phenotype. The patient requested labour analgesia, but the haematology department contraindicated neuraxial techniques, given her history. An ultrasound-guided lumbar erector spinae plane (ESP) block was performed, achieving pain relief after 45 min.</div><div>ESP block could be an alternative to consider when neuraxial analgesia is contraindicated in labour.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 4","pages":"Article 101632"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873721","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":"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}