Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Sonoanatomy of the difficult airway. A case-control study","authors":"P. Kot ,&nbsp;L. Rovira ,&nbsp;M. Granell ,&nbsp;P. Rodriguez ,&nbsp;B. Cano ,&nbsp;S. Pozo ,&nbsp;J. De Andrés","doi":"10.1016/j.redare.2024.101642","DOIUrl":"10.1016/j.redare.2024.101642","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The occurrence of a difficult airway during intubation is a critical event in anaesthesia. Despite the usefulness of clinical predictors, difficult intubation frequently arises unexpectedly. The aim of this study was to determine the utility of airway ultrasound in detecting these patients.</div></div><div><h3>Materials and methods</h3><div>This was a case-control study. The patients in the case group were identified from the registry of patients with reports of difficult laryngoscopy (Cormack III and IV). The controls were selected from among patients classed as Cormack I who underwent surgery under general anaesthesia. Fifty patients (25 cases and 25 controls) participated in the study. All patients underwent ultrasound to obtain 3 measurements: distance from the skin to the hyoid bone, distance from the skin to the epiglottis, and distance from the skin to the vocal cords.</div></div><div><h3>Results</h3><div>A skin-to-hyoid bone distance greater than 9.8 mm (50% of the sample) generated an odds ratio of 5.46 (<em>p</em> = 0.005); a skin-to-epiglottis distance greater than 21.3 mm (50% of the sample) generated an odds ratio of 6.62 (<em>p</em> = 0.002). There was no significant difference in the skin-to-vocal cords distance.</div></div><div><h3>Conclusions</h3><div>Ultrasound has proven to be a useful tool for predicting difficult laryngoscopy. Despite the low sensitivity of clinical predictors, they appear to improve the detection of patients with difficult laryngoscopy when integrated into predictive models alongside ultrasound values.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101642"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633925","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":"Comment on: “Single versus double injection costoclavicular block: non-inferiority trial”","authors":"R.M. Sethuraman,&nbsp;S. Krishnakumar,&nbsp;S. Rajendran","doi":"10.1016/j.redare.2024.101639","DOIUrl":"10.1016/j.redare.2024.101639","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101639"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635436","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 propofol versus sevoflurane on cerebral oxygenation in childhood Moyamoya disease. A near infrared spectroscopy study","authors":"J.R. Seshan,&nbsp;I. Kapoor,&nbsp;H. Prabhakar,&nbsp;C. Mahajan","doi":"10.1016/j.redare.2024.101630","DOIUrl":"10.1016/j.redare.2024.101630","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Anaesthesia during surgery for moyamoya disease (MMD) has different effects on cerebral physiology. Both sevoflurane and propofol have cerebral protective effects, albeit with different mechanisms. We used near infrared spectroscopy (NIRS) to observe the effect of sevoflurane and propofol on rSO₂ in paediatric patients undergoing MMD surgery.</div></div><div><h3>Materials and methods</h3><div>We included paediatric patients ASA grade I aged between 1 and 18 years undergoing surgery for MMD over a period of 1 year (from 1 April 2018 to 1 April 2019). Patients were randomized to 2 groups: Group S (sevoflurane) and Group P (propofol). NIRS values were recorded at 5 time points: T1 (baseline) T2 (after preoxygenation), T3 (after induction), T4 (end of surgery), T5 (after extubation). One-way ANOVA was used for intra-group comparisons and two-way repeated measures ANOVA with Bonferroni correction were used for inter-group comparisons. <em>P</em> value &lt;0.05 was considered significant.</div></div><div><h3>Results</h3><div>A total of 20 patients were included in the study. The average age was 10.5 ± 4.3 years. The mean baseline rSO₂ was 78.35 ± 10.58 and 77.95 ± 8.81 in the right and left hemispheres, respectively. In both groups, rSO₂ values increased between baseline and anaesthesia induction and fell slightly at the end of surgery. The inter-group analysis showed no statistically significant change between rSO₂ values.</div></div><div><h3>Conclusion</h3><div>Both sevoflurane and propofol maintain adequate rSO₂ levels in children undergoing surgery for MMD.</div></div><div><h3>Clinical trial registration number</h3><div>CTRI/2018/04/013229 registered on 12.04.2018.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101630"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635441","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 management of the patients with hip fracture under anticoagulant or antiaggregants treatment. Consensus recommendations from the hemostasis section of SEDAR","authors":"C. Cassinello ,&nbsp;R. Ferrandis ,&nbsp;A. Gómez-Luque ,&nbsp;F. Hidalgo ,&nbsp;J.V. Llau ,&nbsp;G. Yanes-Vidal ,&nbsp;P. Sierra","doi":"10.1016/j.redare.2024.501651","DOIUrl":"10.1016/j.redare.2024.501651","url":null,"abstract":"<div><h3>Background</h3><div>Antiaggregant and anticoagulant therapy complicate the management of patients with osteoporotic hip fracture.</div></div><div><h3>Objective</h3><div>To homogenize and improve daily clinical practice with simple recommendations.</div></div><div><h3>Methods</h3><div>The haemostasis section of SEDAR established a working group to define an action plan for the management of antiaggregated or anticoagulated patients with an osteoporotic hip fracture. The suggested recommendations are based on evidence of best practices, and have been validated by a multidisciplinary group formed by 6 specialties.</div></div><div><h3>Results</h3><div>Early surgery reduces complications and mortality and improves patient comfort and functional recovery, with no difference in mortality between intradural and general anaesthesia.</div></div><div><h3>Conclusion</h3><div>Although uncertainties remain, it is recommended to perform surgery within 24−48 h of admission, adapting peripheral nerve blocks and type of anaesthesia (neuraxial or general) an to the haemostatic conditions. A multimodal management of antithrombotics, and the optimisation of haemostasis, haemoglobin and venous thromboprophylaxis since admission are suggested.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 501651"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786968","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":"Anesthetic management of idiopathic intracranial hypertension during pregnancy. A case report","authors":"D. Revuelta ,&nbsp;M. López-Baamonde ,&nbsp;M. Vendrell ,&nbsp;A. Plaza ,&nbsp;T. Cobo ,&nbsp;M. Magaldi","doi":"10.1016/j.redare.2024.101623","DOIUrl":"10.1016/j.redare.2024.101623","url":null,"abstract":"<div><div>Idiopathic intracranial hypertension (IIH) is a condition characterized by elevated intracranial pressure (ICP) of unknown etiology, more prevalent in obese women of childbearing age. The management of IIH during pregnancy represents a multidisciplinary challenge, as medical treatment is contentious due to the foetal teratogenic risk, and the technically challenging placement of a ventriculoperitoneal shunt is hindered by the presence of the pregnant uterus. The goal of anaesthetic management during childbirth is to maintain hemodynamic stability, cerebral perfusion pressure, and cerebral tissue oxygenation, while avoiding abrupt fluctuations in intracranial pressure. The choice of anaesthetic technique is complex and depends on the assessment of risks and benefits associated with each technique, involving a decision between neuraxial anaesthesia and general anaesthesia.</div><div>We present the case of a pregnant woman with rapidly progressing IIH, approached in a multidisciplinary manner, whose anaesthetic management was technically challenging, resulting in a favourable outcome without subsequent complications.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101623"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635433","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 goal-directed hemodynamic therapy through fluid administration to optimize the stroke volume: A meta-analysis of randomized controlled trials","authors":"J. Ripollés-Melchor ,&nbsp;Á.V. Espinosa ,&nbsp;P. Fernández-Valdes-Bango ,&nbsp;R. Navarro-Pérez ,&nbsp;A. Abad-Motos ,&nbsp;J.V. Lorente ,&nbsp;M.J. Colomina ,&nbsp;E. Sáez-Ruiz ,&nbsp;A. Abad-Gurumeta ,&nbsp;M.I. Monge-García","doi":"10.1016/j.redare.2024.09.004","DOIUrl":"10.1016/j.redare.2024.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical impact of optimizing stroke volume (SV) through fluid administration as part of goal-directed hemodynamic therapy (GDHT) in adult patients undergoing elective major abdominal surgery.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered in the PROSPERO database in January 2024. The intervention was defined as intraoperative GDHT based on the optimization or maximization of SV through fluid challenges, or by using dynamic indices of fluid responsiveness, including stroke volume variation, pulse pressure variation, and plethysmography variation index compared to usual fluid management. The primary outcome was postoperative complications. Secondary outcome variables included postoperative acute kidney injury (AKI), length of stay (LOS), intraoperative fluid administration, and 30-day mortality.</div></div><div><h3>Results</h3><div>A total of 29 randomized controlled trials (RCTs) met the inclusion criteria. There were no significant differences in the incidence of postoperative complications (RR 0.89; 95% CI, 0.78–1.00), postoperative AKI (OR 0.97; (95% IC, 0.55–1.70), and mortality (OR 0.80; 95% CI, 0.50–1.29). GDHT was associated with a reduced LOS compared to usual care (SMD: −0.17 [−0.32; −0.03]). The subgroup in which hydroxyethyl starch was used for hemodynamic optimization was associated with fewer complications (RR 0.79; 95% CI, 0.65–0.94), whereas the subgroup of patients in whom crystalloids were used was associated with an increased risk of postoperative complications (RR 1.08; 95% CI, 1.04–1.12).</div></div><div><h3>Conclusions</h3><div>In adults undergoing major surgery, goal-directed hemodynamic therapy focused on fluid-based stroke volume optimization did not reduce postoperative morbidity and mortality.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 10","pages":"Pages 719-731"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147251","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":"Recommendations of the Pre-anaesthesia Teleconsultation Task Force","authors":"A. Aroca Tanarro ,&nbsp;R. Casans Francés ,&nbsp;M.Á. Gómez-Ríos ,&nbsp;E. Mendez Arias ,&nbsp;M. Otero Pérez ,&nbsp;L. Quecedo Gutierrez ,&nbsp;V. Rojas Pernia ,&nbsp;A. Abad Gurumeta","doi":"10.1016/j.redare.2024.09.001","DOIUrl":"10.1016/j.redare.2024.09.001","url":null,"abstract":"<div><div>The main objectives of the pre-anaesthesia consultation are to establish the patient’s anaesthesia and surgical risk, evaluate and optimize their health status, provide the patient with information and preoperative recommendations, and fulfil the legally established bureaucratic obligations. The incorporation of information technologies - e-Health - has maximised the efficiency of pre-anaesthesia assessments and provided patients with an added benefit.</div><div>The SEDAR Task Force has developed a digital framework as an alternative to the conventional pre-anaesthesia assessment process, and has put forward a series of policies and technical recommendations for the incorporation of different types of pre-anaesthesia teleconsultation services in hospital anaesthesiology departments. We also put forward an evaluation tool that includes several quality indicators on which to base continuous improvements in healthcare.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 10","pages":"Pages 701-709"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147252","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":"Preoperative coagulation tests: A narrative review of current guidelines","authors":"J.L. Jover Pinillos ,&nbsp;R. Ferrandis Comes ,&nbsp;D. Zamudio Penko ,&nbsp;M. Bermúdez López ,&nbsp;M. Basora Macaya ,&nbsp;M.J. Colomina Soler","doi":"10.1016/j.redare.2024.09.005","DOIUrl":"10.1016/j.redare.2024.09.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Hemostasis tests are traditionally requested for all patients requiring any surgical act or invasive diagnostic-therapeutic procedure to prevent hemorrhagic complications. The aim of this study is to assess the necessity of requesting standard pre-procedure hemostasis tests.</div></div><div><h3>Methodology</h3><div>A narrative literature review was conducted using the PubMed data-base. Search terms included «Hemostasis» or «Blood coagulation» in combination with «Preoperative care», «Preoperative period», or «Preoperative procedure». Additionally, a targeted search was performed to find recommendations from international societies related to the topic.</div></div><div><h3>Results</h3><div>A total of 233 articles were found, 17 were pre-selected, and after full-text evaluation, 14 relevant articles were identified. The targeted search yielded an additional 12 articles.</div><div>The request for tests should be individualized according to the clinical history. Standardized screening questionnaires for hemostasis disorders are useful and complement the aforementioned approach. Factors such as age, ASA classification, bleeding potential-complexity of the procedure, and anesthetic technique may influence their request.</div></div><div><h3>Discussion</h3><div>The incidence of hemostasis disorders in the general population is very low, and these can mostly be detected through clinical history. Thus, it is the clinical history that should guide the need for laboratory test requests.</div></div><div><h3>Conclusions</h3><div>Preoperative hemostasis tests should not be indiscriminately requested for all patients needing an intervention or invasive diagnostic-therapeutic procedure, but rather when there are doubts about their hemostatic competence or as advised by the nature of the procedure they are undergoing.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 10","pages":"Pages 740-747"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305203","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":"Validity of estimated aortic pulse wave velocity measured during the 6-min walk test to predict anaerobic fitness before major non-cardiac surgery","authors":"J. Ripollés-Melchor ,&nbsp;M.I. Monge García ,&nbsp;A. Ruiz-Escobar ,&nbsp;E. Sáez-Ruiz ,&nbsp;B. Algar-Yañez ,&nbsp;A. Abad-Motos ,&nbsp;A. Abad-Gurumeta","doi":"10.1016/j.redare.2024.09.002","DOIUrl":"10.1016/j.redare.2024.09.002","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to assess the efficacy of estimated preoperative aortic pulse wave velocity (AoPWV) to discriminate between low and high 6 min walk test (6MWT) distance in patients awaiting major non-cardiac surgery.</div></div><div><h3>Methods</h3><div>Prospective observational study in 133 patients undergoing non cardiac surgery. AoPWV and the distance walked during a 6MWT were assessed. Receiver operating characteristic (ROC) curve analysis was used to determine two different AoPWV cut-points for predicting a distance of 427 m in the 6MWT. We also calculated lower and upper AoPWV cut-points (probability ≥ 0.75) for predicting a distance of &lt; 427 m, ≥427 m, and also 563 m in the 6MWT.</div></div><div><h3>Results</h3><div>The ROC curve analysis for the &lt; 427 m distance revealed an area under the curve (AUC) of 0.68 (95% confidence interval 0.56–0.79) and an AUC of 0.72 (95% confidence interval 0.61–0.83) for &gt;563 m. Patients with AoPWV &gt; 10.97 m/s should be considered high risk, while those with &lt;9.42 m/s can be considered low risk.</div></div><div><h3>Conclusions</h3><div>AoPWV is a simple, non-invasive, useful clinical tool for identifying and stratifying patients awaiting major non-cardiac surgery. In situations of clinical uncertainty, additional measures should be taken to assess the risk.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 10","pages":"Pages 710-718"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157095","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":"Relapsing polichondritis affecting the tracheobronquial tree in a patient with preeclampsia with severe features","authors":"E. Sarrió Badenes ,&nbsp;M. Durá Aranda ,&nbsp;L. Molero Sala ,&nbsp;P. Martín Serrano","doi":"10.1016/j.redare.2024.02.004","DOIUrl":"10.1016/j.redare.2024.02.004","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 10","pages":"Pages 760-761"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725547","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}