Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Effects of ultrasound-guided caudal versus perianal blocks on intraoperative anal sphincter tone and postoperative analgesia during sphincter-sparing procedures: A randomized comparative trial","authors":"A.M. Adel AbdelMoneim,&nbsp;M. Bassem Helmy,&nbsp;M. Adolf Helmy,&nbsp;O. Mohamed Asaad,&nbsp;A. Hassan Saleh,&nbsp;M.H. El-Sherbiny","doi":"10.1016/j.redare.2026.502091","DOIUrl":"10.1016/j.redare.2026.502091","url":null,"abstract":"<div><h3>Background</h3><div>Data comparing the effects of caudal epidural anaesthesia and perianal block during anal sphincter sparing procedures under general anaesthesia are limited. We aimed to compare the efficacy and safety of ultrasound-guided caudal block versus perianal block on anal sphincter muscle tone and in reducing postoperative pain among patients undergoing anal sphincter-sparing procedures.</div></div><div><h3>Methods</h3><div>This randomized double-blinded study enrolled 46 adult patients, American Society of Anesthesiologists physical status I or II, who underwent anal sphincter sparing procedures under general anaesthesia. Patients were randomly assigned to one of two groups (23 patients each). Group A received an ultrasound-guided caudal block, while Group B received a perianal block. The primary outcome was duration of postoperative analgesia. Secondary outcomes included total postoperative morphine consumption, postoperative pain intensity, time to postoperative ambulation, intraoperative external anal sphincter muscle tone by Digital rectal scoring system (DRESS), patient satisfaction, and incidence of complications.</div></div><div><h3>Results</h3><div>Patients in group A had a statistically significant longer time to first request for analgesia and lower morphine consumption than those in group B (2.50 ± 0.27 vs. 1.57 ± 0.53 h, and 3.30 ± 2.18 mg vs. 5.87 ± 2.05 mg, <em>P</em> &lt; .001). Although these differences are modest in magnitude, they may contribute to improved recovery when combined with multimodal analgesia strategies. Moreover, caudal block resulted in shorter time to ambulation (2.17 ± 0.38 vs 3.48 ± 0.53 h), and low numeric pain scores (1.96 ± 0.56 vs. 3.48 ± 0.66, <em>P</em> &lt; .001). The DRESS and Likert scores were significantly higher in patients in group A than in group B (2.83 ± 0.38 vs. 2.22 ± 0.42, and 3.78 ± 0.42 vs. 2.48 ± 0.66, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>In anal sphincter-sparing operations, ultrasound-guided caudal epidural blocks combined with general anaesthesia may improve pain management, reduce opioid requirements, and thereby reduce the incidence of postoperative nausea and vomiting, while maintaining anal sphincter tone compared to local perianal block.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502091"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492453","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":"Diaphragm-sparing shoulder regional anesthesia techniques: Understanding the concepts and clinical applications","authors":"R.M. Sethuraman","doi":"10.1016/j.redare.2026.502038","DOIUrl":"10.1016/j.redare.2026.502038","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502038"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319431","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":"Anaesthethic management on a pediatric patient with Sengers syndrome. Case report","authors":"M.A. Perelló,&nbsp;F.J. Bellafont,&nbsp;E. Pujol-Ayach,&nbsp;M. Alegret","doi":"10.1016/j.redare.2026.502024","DOIUrl":"10.1016/j.redare.2026.502024","url":null,"abstract":"<div><div>Sengers Syndrome is an autosomal recessive mitochondrial myopathy caused by mutations of the acylglycerol kinase gene, which leads to an abnormal musculoskeletal and myocardial lipid and glycogen accumulation. It is characterized by congenital cataracts, hypertrophic cardiomyopathy, skeletal myopathy and lactic acidosis (especially under stress condition). Therefore, cataract surgery might be indicated. Currently there is no treatment or management formalised for this disease, meaning it is a challenge in clinical practice. We introduce a case of perioperative anaesthetic management on a patient with Sengers Syndrome, considering its interest as it is one of the first known cases undergoing general anaesthesia.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502024"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461380","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":"Forestier's disease: The radiograph that anticipates the difficult airway","authors":"M. Arias Salazar,&nbsp;R. Bergé,&nbsp;A. Cayuso,&nbsp;M. Sangrà-Puig","doi":"10.1016/j.redare.2026.502022","DOIUrl":"10.1016/j.redare.2026.502022","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502022"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461391","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":"Response to Sethuraman et al. regarding “Comparison of single-shot neuraxial morphine and erector spinae plane block on quality of recovery after major open gastrointestinal surgeries”","authors":"A. Choudhary,&nbsp;S. Singh","doi":"10.1016/j.redare.2026.502001","DOIUrl":"10.1016/j.redare.2026.502001","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502001"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483203","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":"Interscalene block versus upper trunk block in shoulder arthroscopy: Randomized comparative study of the ease between the two techniques among residents","authors":"A.M.M. Ahmed,&nbsp;M.A. Moustafa,&nbsp;A.S. Alabd","doi":"10.1016/j.redare.2026.502092","DOIUrl":"10.1016/j.redare.2026.502092","url":null,"abstract":"<div><h3>Introduction</h3><div>Interscalene brachial plexus block (ISB) remains the gold standard nerve block in shoulder arthroscopic surgery. However, some anatomical variations exist in addition to several reported complications and technical challenges. Upper trunk block (UTB) may be a feasible alternative. The primary outcome was the success rate of UTB and ISB. Secondary outcomes included: duration of block performance, guidance interventions, visualization of anatomic structures, postoperative pain and opioid consumption, and diaphragmatic function.</div></div><div><h3>Methods</h3><div>One hundred and twenty patients were divided randomly into 2 groups; 60 patients received ISB before general anaesthesia (GA) and 60 patients received UTB before GA. All blocks were performed by anaesthesia trainees under supervision of an attending consultant.</div></div><div><h3>Results</h3><div>Age, sex, BMI, and duration of surgery were not different statistically. The duration of block performance was significantly longer in the ISB group (P = 0.002). Guidance interventions in the ISB group were higher than the UTB group (P &lt; 0.001). There were no significant differences regarding the worst postoperative pain score (P = 0.574), postoperative nalbuphine consumption (P = 0.813) or success rate (P = 0.31) between groups. Visualization of the anatomic structures in the 2 groups was not statistically significant (P = 0.183). Diaphragmatic function was significantly affected in the ISB group (45% complete paralysis and 35% paresis) versus (8.3% complete paralysis and 30% paresis) in the UTB group.</div></div><div><h3>Conclusions</h3><div>UTB may be considered a safer and a technically easier approach than ISB for providing equivalent intra and postoperative regional analgesia in arthroscopic shoulder surgery by anaesthesia trainees.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502092"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505885","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":"Challenges and opportunities for personalized analgesia","authors":"S. López Álvarez","doi":"10.1016/j.redare.2026.502031","DOIUrl":"10.1016/j.redare.2026.502031","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502031"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461378","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":"Creation and validation of a competency and error metrics for the orotracheal intubation technique using an angled blade video laryngoscope (GlideScope®)","authors":"M. Coll-Badell ,&nbsp;J.V. Serrano-Gonzalvo ,&nbsp;L. Carrillo-Luna ,&nbsp;J.M. Soto-Ejarque ,&nbsp;C. Ramírez-Miranda ,&nbsp;C. Añez-Simón","doi":"10.1016/j.redare.2026.502071","DOIUrl":"10.1016/j.redare.2026.502071","url":null,"abstract":"<div><h3>Objectives</h3><div>The main objective of this study was to create and validate a metric for the correct performance of orotracheal intubation with an angled blade video laryngoscope (GlideScope®). The secondary objectives were to break down the technique into correct phases and steps (competency metrics), define errors and critical errors.</div></div><div><h3>Method</h3><div>Prospective observational study divided into two phases. In phase I, the metric was created: a group of experts deconstructed the procedure, identifying phases and defining the competence metrics and errors with the help of three previous recordings. The metrics were stress-tested for objectivity and consensus was sought in a meeting of 24 experts using the modified Delphi methodology.</div><div>In phase II, the metric was validated by recording 9 experienced and 9 novice professionals performing the procedure on a mannequin. Subsequently, 2 external evaluators, previously trained in the use of the metric, evaluated the videos independently.</div></div><div><h3>Results</h3><div>A metric was created, defined by 4 phases, 22 competency metrics, and 31 errors, of which 16 were considered critical. Experienced professionals completed more competency metrics than novices (17.05 vs. 13.72 (p = 0.010), had fewer total errors (p = 0.0017) and fewer critical errors 0.55 vs. 2.61 (p &lt; 0.001). Inter-rater agreement for the total score of all videos was &gt;0.80.</div></div><div><h3>Conclusions</h3><div>The metric created is valid and reliably discriminates between operators who are competent and those who are not competent in performing the technique.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502071"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505891","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":"Comparative evaluation of intranasal dexmedetomidine and midazolam as premedication for children undergoing corrective surgery for congenital heart disease: A randomized clinical trial","authors":"R. Sharma ,&nbsp;S. Singh ,&nbsp;R. Nair ,&nbsp;M. Dhiman ,&nbsp;P. Taank","doi":"10.1016/j.redare.2026.502029","DOIUrl":"10.1016/j.redare.2026.502029","url":null,"abstract":"<div><h3>Background</h3><div>Premedication is essential in paediatric surgery for smooth induction and anxiety relief. Common agents—ketamine, midazolam, dexmedetomidine, and fentanyl—are administered via intramuscular injection, intravenous infusion, or oral routes, but efficacy varies and no consensus exists on an optimal protocol. Intranasal delivery offers a promising, more comfortable alternative with potential to improve outcomes.</div></div><div><h3>Methods</h3><div>This double-blind randomized trial evaluated intranasal dexmedetomidine (1 mcg/kg) (group D) versus midazolam (0.2 mg/kg) as premedication in 90 children (2–12 years) (group M) undergoing corrective surgery for acyanotic congenital heart disease (CHD). Sedation, parental separation anxiety, mask acceptance, and hemodynamic parameters were evaluated.</div></div><div><h3>Results</h3><div>Acceptable sedation was achieved in 62.2% of children in group D and 53.3% in group M. Group D showed superior anxiolysis during separation from parents (93.3% vs. 73.3%) and better mask acceptance during induction (93.3% vs. 53.3%). A statistically significant but clinically mild decrease in diastolic BP occurred in the dexmedetomidine group without adverse effects.</div></div><div><h3>Conclusion</h3><div>Both drugs were effective as intranasal premedication. However, dexmedetomidine showed better results in sedation, less anxiety upon separation from parents, and greater acceptance of the mask, without significant side effects.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 3","pages":"Article 502029"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151615","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 using intrathecal mu-receptor antagonist in preventing pruritus and PONV after spinal anesthesia – A systematic review and meta-analysis","authors":"A.U. Huda ,&nbsp;R. Fernando ,&nbsp;H.B. Ghafoor ,&nbsp;R. Minhas","doi":"10.1016/j.redare.2026.502034","DOIUrl":"10.1016/j.redare.2026.502034","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and objective&lt;/h3&gt;&lt;div&gt;Different adjuvants are used in combination with intrathecal local anesthesia to improve the quality of spinal anesthesia. Opioids are most used for this purpose, but these are associated with side effects such as pruritus and postoperative nausea and vomiting. Various medications have been utilized for prophylaxis or treatment of these side effects especially pruritus. Although mu-receptor antagonists are generally used intravenously or subcutaneously for the treatment of pruritus, few studies have investigated the role of intrathecal mu-receptor antagonists. So, this systematic review aimed to evaluate the effect of using intrathecal mu-receptor antagonists when used with local anesthetics like bupivacaine, and opioids for the prevention of opioid-related side effects.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;This meta-analysis was conducted while following PRISMA guidelines. We registered this review with the PROSPERO database in February 2025. Two authors performed the literature searches in February 2025 and then repeated after one month to ensure accuracy. Two authors independently appraised the individual studies according to the Consolidated Standards of Reporting Trials checklist. Literature search was done using online databases including PubMed, Google Scholar, Science Direct and Cochrane library. Potential bias was evaluated using the risk of bias-2 (RoB-2) tool. We included randomized controlled trials that compared intrathecal mu-receptor antagonists with control for patients undergoing surgery under spinal anesthesia. The primary outcome of the study was the incidence of pruritus. We utilized the Review manager software, RevMan for MAC 5.4, to conduct the meta-analysis. Mean difference (MD), standard mean difference (SMD) and odds ratios (OR) were calculated for different outcomes. Using random effect models, Peto odd ratios were used for weighing models. Funnel plots and Egger’s test were utilized to assess the risks for publication bias across studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 9 randomised controlled trials (n = 653) were included in this systematic review and meta-analysis. The incidence of pruritus in mu-receptor antagonist group was 19.3 vs 58.8 in the control group with an OR of 0.15 [&lt;em&gt;P&lt;/em&gt; &lt; .00001, (CI 0.11−0.21)]. Mu-receptor antagonists significantly reduced the incidence of PONV with an OR of 0.26 [&lt;em&gt;P&lt;/em&gt; &lt; .00001, (CI 0.18−0.36)]. I&lt;sup&gt;2&lt;/sup&gt; value for pruritus was 32% while it was 72% for PONV. There was no significant difference in VAS pain scores between two groups during the first 24 h except at 2 h postoperatively. Furthermore, the use of intrathecal mu-receptor antagonists did not significantly affect the time to first analgesic request.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The use of intrathecal mu-receptor antagonists significantly reduces the occurrence of opioid-related side effects such as pruritus and PONV.&lt;/div","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 3","pages":"Article 502034"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168650","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}