Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Transorbital intubation in a patient with difficult airway due to previous surgery","authors":"M.E. Navío Poussivert, A. Martinez-Garcia, M.I. de la Rosa Jiménez","doi":"10.1016/j.redare.2024.02.003","DOIUrl":"10.1016/j.redare.2024.02.003","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 10","pages":"Page 772"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725549","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":"Use of fluid therapy in perioperative adult patients: A narrative review","authors":"M.J. Colomina ,&nbsp;P. Galán Menéndez ,&nbsp;J. Ripollés-Melchor","doi":"10.1016/j.redare.2024.09.003","DOIUrl":"10.1016/j.redare.2024.09.003","url":null,"abstract":"<div><div>The administration of intravenous fluids is the most common intervention in hospitalised patients in the perioperative setting and critical care units. The aim of this narrative review is to provide an overview of balanced solutions for fluid therapy in the perioperative period in adult patients, and to review new trends and solutions in fluid therapy.</div><div>The evidence was grouped into 3 areas: intraoperative fluid administration, fluid administration in critically ill patients, and the importance / benefit of balanced crystalloid solutions.</div><div>Although a number of high-quality studies have been published in recent years, the scientific evidence regarding the type of fluid, the dose, and rate of administration is still limited. The choice of fluid therapy during the perioperative period must be tailored to patient-specific factors, the nature of the surgery, expected fluid loss, and other relevant factors. Finally, more robust clinical evidence and physician training is of the utmost importance.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 10","pages":"Pages 748-759"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147253","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":"National survey on perioperative cognitive dysfunction","authors":"E.M. Aldana ,&nbsp;N. Pérez de Arriba ,&nbsp;J.L. Valverde ,&nbsp;C. Aldecoa ,&nbsp;N. Fábregas ,&nbsp;J.L. Fernández-Candil ,&nbsp;on behalf of the Neuroscience Section Working Group","doi":"10.1016/j.redare.2024.07.004","DOIUrl":"10.1016/j.redare.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><div>Perioperative cognitive dysfunction (PCD) is a very prevalent clinical syndrome due to the progressive aging of the surgical population.The aim of our study is to evaluate the clinical practice of Spanish anesthesiologists surveyed regarding this entity.</div></div><div><h3>Material and methods</h3><div>Prospective online survey conducted by the Neurosciences Section and distributed by SEDAR.</div></div><div><h3>Results</h3><div>544 responses were obtained, with a participation rate of 17%. 54.4% of respondents never make a preoperative assessment of cognitive impairment, only 7.5% always do it. 79.6% lack an intraoperative management protocol for the patient at risk of PCD. In the anesthetic planning, only 23.3% of the patients was kept in mind. Eighty-nine percent considered regional anesthesia with or without sedation preferable to general anesthesia for the prevention of PCD. 88.8% considered benzodiazepines to present a high risk of PCD. 71.7% considered that anesthetic depth monitoring could prevent postoperative cognitive deficit. Routine evaluation of postoperative delirium is low, only 14%. More than 80% recognize that PCD is underdiagnosed.</div></div><div><h3>Conclusions</h3><div>Among Spanish anesthesiologists surveyed, PCD is still a little known and underappreciated entity. It is necessary to raise awareness of the need to detect risk factors for PCD, as well as postoperative assessment and diagnosis. Therefore, the development of guidelines and protocols and the implementation of continuing education programs in which anesthesiologists should be key members of multidisciplinary teams in charge of perioperative care are suggested.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 9","pages":"Pages 660-669"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556309","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 pulmonary artery banding in adult patient with single ventricle and uncorrected transposition of the great arteries","authors":"M. Ribas Ball ,&nbsp;M. de Miguel Negro ,&nbsp;P. Galán Menéndez ,&nbsp;L. Dos Subirà ,&nbsp;M.A. Castro Alba ,&nbsp;G. Martí Aguasca","doi":"10.1016/j.redare.2024.02.030","DOIUrl":"10.1016/j.redare.2024.02.030","url":null,"abstract":"<div><div><span><span>Pulmonary artery banding (PAB) is a procedure mainly performed during the </span>neonatal period as an initial stage to definitive palliative reconstruction, a scenario in which the criteria for banding adjustment are well defined. However, the indication for BAP in the adult is extraordinarily rare, even more in patients with </span>single ventricle<span> and unrepaired transposition of the great arteries (TGA), and there are no established criteria for banding adjustment. Due to the small number of these procedures, there is limited experience in their anesthetic management and complications.</span></div><div><span>We describe a case of a 29-year-old patient diagnosed with a cyanotic congenital heart disease of double-inlet left ventricle with TGA and unrepaired </span>mitral stenosis<span>, who underwent to a hybrid procedure of PAB and enlargement of the communication between the two atria.</span></div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 9","pages":"Pages 687-691"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013879","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":"Bispectral index monitoring for sedation in scheduled adult colonoscopy: A randomized controlled trial","authors":"I. González-Mendibil ,&nbsp;E. García-Pascual ,&nbsp;A. Villanueva ,&nbsp;S. García-Gutiérrez","doi":"10.1016/j.redare.2024.04.011","DOIUrl":"10.1016/j.redare.2024.04.011","url":null,"abstract":"<div><h3>Background</h3><div><span>Patients should be closely monitored during procedures under sedation outside the operating room, but it is unclear which type of monitoring is best. We investigated the efficacy and safety of BIS monitoring vs conventional monitoring for sedation during </span>colonoscopy.</div></div><div><h3>Methods</h3><div><span><span>We performed a double-blind clinical trial in 180 patients undergoing elective colonoscopy. Patients were randomized to 1) the BIS group or 2) a control group, in which sedation was monitored with a BIS monitor or the </span>Ramsay Sedation Score<span>, respectively. The primary outcome was the rate of sedation-induced adverse events in both groups. Secondary outcomes were the characteristics of patients who developed adverse events, and time during colonoscopy when these events occurred, </span></span>propofol<span> and remifentanil dosage, and patient satisfaction.</span></div></div><div><h3>Results</h3><div>Univariate analysis<span> showed fewer cardiopulmonary complications in the BIS group (41.11% vs 57.78% in controls; p = 0.02). Multivariate analysis<span><span> found a significantly higher risk of adverse events in older patients (95% CI, 1.013–1.091; p = 0.0087) and in men (95% CI, 1.129–7.668; p = 0.0272). These events were observed at the hepatic flexure. No significant differences between propofol or </span>remifentanil<span> dosage, use of rescue medication, and patient satisfaction were observed between groups.</span></span></span></div></div><div><h3>Conclusions</h3><div>Our data suggest that BIS monitoring during sedation in scheduled colonoscopies reduces adverse respiratory events. Although its routine use in sedation does not appear to be warranted, clinicians should take steps to identify patients with a higher risk of complications who might benefit from this type of monitoring.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 9","pages":"Pages 633-644"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763866","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":"Comparison of intranasal dexmedetomidine and ketamine for paediatric premedication: A randomized study","authors":"N. Kumari,&nbsp;P.K. Dubey,&nbsp;S. Singh","doi":"10.1016/j.redare.2024.07.003","DOIUrl":"10.1016/j.redare.2024.07.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Paediatric patients are given premedication in order to decrease preoperative anxiety, allow smooth induction, and prevent postoperative psychological insult and behavioural changes. A child friendly method of administration is desirable.</div><div><span>We compared intranasal administration of </span>dexmedetomidine<span><span> and ketamine in the operating room environment, to evaluate the Faces, Legs, Activity, Cry and Consolability (FLACC) score at the time of establishing intravenous access for induction of </span>general anaesthesia.</span></div></div><div><h3>Methods</h3><div>This prospective, double-blind, randomized controlled trial<span> was conducted at a tertiary care center. One hundred patients, 2–10 years of age, ASA<span><span> physical status 1 &amp; 2, scheduled for general anaesthesia were enrolled. Patient’s presedation behaviour was assessed by the modified Yale Preoperative Anxiety Scale Short Form (mYPAS-SF). Patients in Group D received Dexmedetomidine 1 mcg/kg intranasally, and patients in Group K received Ketamine 5 mg/kg intranasally. After 45 min, patients were transferred to the operating table where intravenous cannulation was carried out and the response to needle insertion was assessed by FLACC scale. Vital signs, including the pulse-oximetry, heart rate and respiratory rate were monitored. </span>Side effects such as nausea, vomiting, and agitation were also recorded.</span></span></div></div><div><h3>Results</h3><div>A significantly higher FLACC score was seen in Group D as compared to Group K (<em>p</em> = 0.001). The mean heart rate between two groups was found to be significantly (<em>p</em><span> = 0.001) lower in Group D compared to Group K. However, the proportion of adverse events<span> was 8% in patients who received ketamine.</span></span></div></div><div><h3>Conclusions</h3><div>Intranasal ketamine in a dose of 5 mg/kg is clinically more effective as premedication in children aged 2–10 years in comparison with intranasal dexmedetomidine in a dose of 1 mcg/kg.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 9","pages":"Pages 652-659"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556308","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":"Sepsis due to liver abscess diagnosed by ultrasound in the ICU","authors":"J.F. Muñoz Moreno,&nbsp;E. Rubio Prieto,&nbsp;A. Peral Santos,&nbsp;L. Segovia García de Marina","doi":"10.1016/j.redare.2024.02.008","DOIUrl":"10.1016/j.redare.2024.02.008","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 9","pages":"Page 697"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725548","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":"Veno-arterial extracorporeal membrane oxygenation (ECMO VA) as part of a multimodal approach for the protection of spinal cord ischemia in surgical repair of a thoracoabdominal aneurysm","authors":"F.E. Fernández-Suárez ,&nbsp;J.M. López-González ,&nbsp;C.M. Fernández-Vallina ,&nbsp;V. Cueva-Carril ,&nbsp;B.M. Jiménez Gómez ,&nbsp;J. García-Menéndez","doi":"10.1016/j.redare.2024.02.023","DOIUrl":"10.1016/j.redare.2024.02.023","url":null,"abstract":"<div><div>Spinal cord ischaemia<span><span> leading to paraplegia or paraparesis is one of the most devastating complications of </span>aortic surgery. The risk of ischaemia is particularly high in repairs involving both the thoracic and abdominal segments, because in these cases blood flow to the spinal arteries can be interrupted.</span></div><div>Multimodal protocols have now been developed to reduce the incidence of this complication, and include measures such as cerebrospinal fluid (CSF) drainage, avoidance of hypotension and anaemia, systemic hypothermia, neuromonitoring, maintaining distal perfusion during proximal clamping of the aorta, and reimplantation<span> of intercostal or lumbar arteries, whenever feasible.</span></div><div><span>We describe a case in which, due to the special characteristics of the surgery, veno-arterial extracorporeal membrane oxygenation (VA ECMO) was used to maintain distal blood flow in the lumbar, inferior mesenteric, and hypogastric arteries during </span>aortic clamping<span>. This approach reduced the risk of spinal cord and visceral ischaemia, and also eliminated the need for thoracotomy because partial left bypass was not required.</span></div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 9","pages":"Pages 692-696"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998757","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 perforation after total thyroidectomy","authors":"B. Estero Serrano de la Cruz ,&nbsp;M. Ruano Santiago ,&nbsp;E. Herrera Martín ,&nbsp;P. Ramos Curado","doi":"10.1016/j.redare.2023.12.002","DOIUrl":"10.1016/j.redare.2023.12.002","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 9","pages":"Pages 698-699"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138613179","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":"A pain in the pocket: Prevalence of pocket pain in patients with implantation of neuromodulation systems: A retrospective study","authors":"J. García Baos ,&nbsp;Á. Huete Marañés ,&nbsp;Á. Mingote ,&nbsp;A. Mendiola de la Osa ,&nbsp;M. Herrero Trujillano ,&nbsp;C. Ágreda García ,&nbsp;S.H. Martínez Rodríguez ,&nbsp;J. García Fernández","doi":"10.1016/j.redare.2024.07.002","DOIUrl":"10.1016/j.redare.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Implantable pulse generator<span> (IPG) is a neurostimulation therapy mediated by electrodes and surgically implanted in a subcutaneous \"pocket\" used for the control of numerous pathologies. This study examines both the prevalence of pain associated with IPG implantation (\"pain pocket syndrome\") and its associated characteristics.</span></div></div><div><h3>Materials and methods</h3><div>56 patients with an IPG were included in the study. A health questionnaire was conducted to determine the presence of pain associated with the pocket and its neuropathic characteristics, as well as associated aesthetic concerns, location, situations that accentuate or alleviate pain, medications used for baseline and pocket pain control and other factors associated.</div></div><div><h3>Results</h3><div>Pain in the area of implantation of the IPG had a prevalence of 52.6% of patients (<em>n</em> = 27), in our sample, with a mean score on the visual analogic scale (VAS) of 4.9 points [3.9–5.8 points], with neuropathic characteristics in 53.3% (<em>n</em> = 16) of the patients with pain, with differences between the mean VAS score of the female (5.5 [4.3–5.8 points]) and males (3.5 points [2.1–4.9 points]) (<em>p</em> = 0.04).</div></div><div><h3>Conclusion</h3><div>Pocket pain is a condition with a higher prevalence than described in previous studies, being of a higher intensity in females, involving a moderate pain in the area of implantation of the neuromodulating therapy. This pain has neuropathic characteristics and could require a repositioning intervention. Hence, more studies in this field should be carried to detect and prevent this syndrome.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 9","pages":"Pages 645-651"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556307","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}