Revista espanola de anestesiologia y reanimacion最新文献_第9页

Gasserian ganglion stimulation for refractory trigeminal neuropathic pain 刺激加瑟神经节治疗难治性三叉神经痛

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.04.008

{"title":"Gasserian ganglion stimulation for refractory trigeminal neuropathic pain","authors":"","doi":"10.1016/j.redare.2024.04.008","DOIUrl":"10.1016/j.redare.2024.04.008","url":null,"abstract":"<div><h3>Background and objective</h3><p>Painful trigeminal neuropathy is a complex clinical entity due to its severity and refractoriness to pharmacological and interventional management. We describe our experience in treating refractory painful trigeminal neuropathy (RPTN) with gasserian ganglion stimulation (GGS).</p></div><div><h3>Materials and methods</h3><p><span>Six patients with RPTN were treated with GGS in our Unit between 2019 and 2022. The following data were collected: socio-demographic characteristics, triggering event, duration of the disease and treatment received prior to surgery, pre- and post-intervention visual analogue scale (VAS) score, follow-up time, and pre- and post-intervention functionality and </span>quality of life.</p></div><div><h3>Results</h3><p>All patients were women who had received aggressive first-, second-, and third-line pharmacological, non-pharmacological, and interventional management before being referred for GGS. Patients reported a 50%–72% decrease in pain on VAS and improved functionality during follow-up.</p></div><div><h3>Conclusions</h3><p>GGS is a promising therapeutic alternative for patients with RPTN. Although the initial outcomes and experience are encouraging, RPTN is recommended on the basis of safety, reproducibility, and trends observed in clinical practice.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 7","pages":"Pages 530-537"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771972","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}

引用次数: 0

Role of VV ECMO tracheal surgery and carinal resection: Two case reports VV ECMO 气管手术和气管切除术的作用：两例报告

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.02.025

{"title":"Role of VV ECMO tracheal surgery and carinal resection: Two case reports","authors":"","doi":"10.1016/j.redare.2024.02.025","DOIUrl":"10.1016/j.redare.2024.02.025","url":null,"abstract":"<div><p><span><span><span>The aim of this study is to describe the anaesthesia management of two patients undergoing carinal resection under veno-venous extracorporeal membrane oxygenation<span><span> (VV ECMO). In both cases, anaesthesia was induced and then maintained with inhalational agents during pneumonectomy and </span>mediastinoscopy<span> (respectively). Then the jugular and femoral veins were cannulated and VV ECMO was started after </span></span></span>heparinization. One of the patients presented bleeding during surgery, which was treated with low-dose vasopressors (norepinephrine) and transfusion of platelets, fresh frozen plasma, and concentrated red blood cells. During VV ECMO, anaesthesia was maintained with target-controlled infusion of </span>propofol. VV ECMO can be expected to improve surgical conditions in </span>tracheal surgery; however, it is still a novel technique in this context. In selected patients, it would guarantee ventilatory support during carinal resection, but it is essential to carefully plan anaesthesia maintenance and prepare for VV ECMO-related complications. This technique should only be used in tertiary centres with experience in VV ECMO management.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 7","pages":"Pages 545-548"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013882","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}

引用次数: 0

Hyperlacticaemia in children with status asthmaticus. The Stewart approach 哮喘状态儿童的高乳酸血症。斯图尔特方法

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.04.010

{"title":"Hyperlacticaemia in children with status asthmaticus. The Stewart approach","authors":"","doi":"10.1016/j.redare.2024.04.010","DOIUrl":"10.1016/j.redare.2024.04.010","url":null,"abstract":"<div><h3>Background</h3><p>Patients with status asthmaticus<span> (SA) frequently present with lactic acidosis (LA). Our goal is to identify the nature of this LA using the Stewart physicochemical model and to identify the independent factors associated with LA in children with SA.</span></p></div><div><h3>Methods</h3><p>Analytical study of a retrospective cohort using a nested case-control design. Twenty-eight episodes of SA in 24 children were included. Patients admitted to a paediatric intensive care unit (PICU) for SA over a 9-year period were recruited consecutively. Data were analysed using the Stewart model and the Strong Ion Calculator. Data were analysed using descriptive statistics and regression models were fitted within the general linear model.</p></div><div><h3>Results</h3><p><span><span>Hyperlacticaemia (Lact[mM/L] = 3.905 [95% CI = 3.018–4.792]) and acidosis (pH = 7.294 [95% CI = 7.241–7.339]) were observed in 18 episodes (15 patients; 62.5%). According to the Stewart model, acidosis was caused by a decrease in strong ion difference. Initially, pCO2 was high (pCO2[mmHg] = 45.806 [95% CI = 37.314–54.298]) but the net unmeasured ion (NUI) component was normal (NUI = −4,461 [95% CI = −3.51 to −5.412]), and neither changed significantly over the clinical course. There was no need to determine </span>pyruvate, as the NUI was normal and the LA was type B (non-hypoxic, lactate/pyruvate < 25). We observed a correlation (</span><em>P</em><span> = .023) between LA and intramuscular epinephrine administered on arrival at hospital, but not between LA and the cumulative dose of nebulized salbutamol.</span></p></div><div><h3>Conclusions</h3><p>Most patients with SA presented LA. The Stewart model confirmed that LA is not hypoxic, probably due to sympathomimetic-related glycolysis.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 7","pages":"Pages 501-505"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793501","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}

引用次数: 0

Veno-venal extracorporeal membrane oxygenation to support whole-lung lavage in a severe case of pulmonary alveolar proteinosis 静脉体外膜肺氧合支持肺泡蛋白沉积症重症病例的全肺灌洗

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2023.12.005

引用次数: 0

How a single perioperative delirium case can make the difference 一个围手术期谵妄病例是如何产生影响的？

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.04.003

引用次数: 0

Ultrasound monitoring to detect embolic phenomena in the inferior vena cava during hip arthroplasty 髋关节置换术中检测下腔静脉栓塞现象的超声监测。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.04.017

{"title":"Ultrasound monitoring to detect embolic phenomena in the inferior vena cava during hip arthroplasty","authors":"","doi":"10.1016/j.redare.2024.04.017","DOIUrl":"10.1016/j.redare.2024.04.017","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p><span>Embolic phenomena frequently occur during hip joint replacement surgery, and may lead to haemodynamic instability in frail patients. Transoesophageal ultrasound monitoring is rarely available in non-cardiac operating theatres, and cannot be performed in awake patients under </span>spinal anaesthesia<span><span>. The main objectives of this prospective exploratory study were to determine the feasibility of using an alternative ultrasound approach to monitor the inferior vena cava during </span>hip replacement surgery, and to determine the intra and interobserver reliability of the ultrasound findings.</span></p></div><div><h3>Method</h3><p><span>We conducted a prospective exploratory study in 20 patients undergoing cemented hip arthroplasty in the </span>supine position under spinal anaesthesia and sedation. The inferior vena cava was assessed through a subcostal window at 10 intraoperative time points, and the findings were rated on a qualitative embolism severity scale. The ultrasound images were evaluated by 2 independent observers.</p></div><div><h3>Results</h3><p>An adequate subcostal window was obtained in 90% of cases. Intra- and inter-observer reliability was high (kappa index >0.80, p < 0.001). Nearly all (95%) patients presented some degree of embolism, which was severe in 50% of cases.</p></div><div><h3>Conclusions</h3><p>Our study suggests that ultrasound assessment of embolic phenomena in the inferior vena cava through a subcostal window is feasible in 90% of cases. The qualitative embolic severity rating scale is highly reproducible and has high intra- and inter-observer reliability.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 7","pages":"Pages 506-513"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859453","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}

引用次数: 0

NRFit connectors in regional anaesthesia: avoiding medication errors 区域麻醉中的 NRFit 连接器：避免用药错误。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.04.012

引用次数: 0

Sarcopenia measured by tomography as a predictor of morbidity and mortality in thoracic surgery, a retrospective cohort study 通过断层扫描测量的 "肌肉疏松症 "可预测胸外科手术的发病率和死亡率。一项回顾性队列研究。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.05.001

{"title":"Sarcopenia measured by tomography as a predictor of morbidity and mortality in thoracic surgery, a retrospective cohort study","authors":"","doi":"10.1016/j.redare.2024.05.001","DOIUrl":"10.1016/j.redare.2024.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Sarcopenia<span><span> has been identified as a risk factor for perioperative adverse events. Several studies have shown that tomographic assessment of muscle mass can be an appropriate indicator of sarcopenia associated with morbidity and mortality. The aim of the study was to determine the association between height-adjusted area of the pectoral and erector spinae muscles (haPMA and haESA) and perioperative morbidity and mortality in </span>thoracic surgery.</span></p></div><div><h3>Methods</h3><p><span>Retrospective cohort study. Measurement of muscle areas was performed by </span>tomography<span>. The outcomes were 30-day mortality and postoperative morbidity. The discriminative capacity of the muscle areas was evaluated with an analysis of ROC curves and the Youden index was used to establish a cut-off point. The raw morbidity and mortality risk was determined and adjusted for potential confounders.</span></p></div><div><h3>Results</h3><p>A total of 509 patients taken to thoracic surgery were included. The incidence of 30-day mortality was 7.3%. An association was found between muscle areas and 30-day mortality and pneumonia, with adequate discriminative power for mortality (AUC 0.68 for haPMA and 0.67 for haESA). An haPMA less than 10 and haESA less than 8.5 cm<sup>2</sup>/m<sup>2</sup> were identified as a risk factor for 30-day mortality with an adjusted OR of 2.34 (95%CI 1.03–5.15) and 2.22 (95%CI 1.10–6.04) respectively.</p></div><div><h3>Conclusions</h3><p>Sarcopenia, defined as low muscle area in the pectoral and erector spinae muscles, is associated with increased morbidity and mortality in patients undergoing thoracic surgery.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"71 7","pages":"Pages 522-529"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892988","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}

引用次数: 0

Postoperative hypotension: Is intraoperative use of dexmedetomidine safe in frail patients? 术后低血压：术中使用右美托咪定对体弱患者安全吗？

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 Epub Date: 2024-05-14 DOI: 10.1016/j.redare.2024.05.002

D Lopez-Lopez, R Mato-Bua, P Neira-Somoza, E Turrado-Blanco

引用次数: 0

Chest compressions as a rescue manoeuvre to maintain aortic valve opening during left ventricular distention syndrome on venoarterial ECMO 在静脉-动脉 ECMO 患者出现左心室扩张综合征时，将胸外按压作为维持主动脉瓣开放的抢救手段。

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redare.2024.02.028

引用次数: 0