Revista Espanola de Anestesiologia y Reanimacion最新文献

英文中文

Reflexiones sobre: «Comparación de los bloqueos en el plano de los músculos serrato y erector de la columna para analgesia postoperatoria en la cirugía de mama unilateral» 关于“单侧乳腺手术术后镇痛作用于脊柱勃起肌平面阻塞的比较”的思考

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion

Pub Date : 2025-12-01 DOI: 10.1016/j.redar.2025.501927

R.M. Sethuraman, R. Aravindan, Y. Mariam

引用次数: 0

Dolor crónico tras trasplante hepático: estudio transversal 肝移植后的慢性疼痛：横断面研究

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion

Pub Date : 2025-12-01 DOI: 10.1016/j.redar.2025.501953

A. Duarte, F. Farias, V. Pires, R. Poeira, M. Canas

Introduction

Chronic post-surgical pain (CPSP) is a major concern following liver transplantation. Despite advancements in surgical and anaesthesia techniques, CPSP remains prevalent and under-researched.

Methods

This cross-sectional retrospective study was conducted at Hospital Curry Cabral, Lisbon, Portugal, in patients who underwent liver transplantation between January 2017 and December 2021. A total of 310 patients participated, exceeding the minimum sample size of 247 required for statistical significance. Data were collected from questionnaires administered over the phone — the Brief Pain Inventory Short Form (BPI-SF) and the Douleur Neuropathique en 4 Questions (DN4) — and from a review of each patient's clinical history.

Results

CPSP was identified in 20.0% of patients, with a higher prevalence in women (27.6%) compared to men (17.0%) (odds ratio: 1.85; 95% confidence interval: 1.03-3.33; P = .019). Acute postoperative pain and female gender were significant independent predictors. Neuropathic pain characteristics were present in 25.8% of cases. We found that CPSP significantly interfered with daily activities, but despite its high incidence, only 24.2% of patients were receiving treatment for their pain.

Discussion

Our findings highlight the impact of CPSP on liver transplant recipients and the need for improved pain management. The study underscores the importance of addressing acute postoperative pain to prevent the development of CPSP and calls for heightened awareness and better treatment protocols to enhance outcones.

Conclusion

This study provides insights into the prevalence and impact of CPSP among liver transplant patients, and identifies acute postoperative pain and female gender as risk factors. The results show the need to improve pain management practices in order to mitigate the long-term effects of CPSP.

慢性术后疼痛（CPSP）是肝移植术后的主要问题。尽管手术和麻醉技术取得了进步，但CPSP仍然普遍存在，研究不足。方法本横断面回顾性研究在葡萄牙里斯本的Curry Cabral医院进行，研究对象为2017年1月至2021年12月期间接受肝移植的患者。共有310例患者参与，超过了统计意义所需的最小样本量247例。数据收集自通过电话进行的问卷调查——简短疼痛调查表（BPI-SF）和双神经病变4个问题（DN4）——以及对每位患者的临床病史的回顾。结果20.0%的患者存在scpsp，其中女性（27.6%）高于男性（17.0%）（优势比：1.85；95%可信区间：1.03 ~ 3.33;P = 0.019）。术后急性疼痛和女性性别是显著的独立预测因素。25.8%的病例存在神经性疼痛特征。我们发现CPSP明显干扰日常活动，但尽管发病率很高，但只有24.2%的患者接受了治疗。我们的研究结果强调了CPSP对肝移植受者的影响以及改善疼痛管理的必要性。该研究强调了解决急性术后疼痛的重要性，以防止CPSP的发展，并呼吁提高认识和更好的治疗方案，以提高结果。结论本研究揭示了肝移植患者CPSP的患病率及其影响，并确定了术后急性疼痛和女性性别为危险因素。结果表明，需要改善疼痛管理实践，以减轻CPSP的长期影响。

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引用次数: 0

Efecto Macklin en pacientes de COVID-19 críticos: análisis unicéntrico observacional 2019冠状病毒病重症患者的麦克林效应：单中心观察分析

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion

Pub Date : 2025-12-01 DOI: 10.1016/j.redar.2025.501930

G. Melegari , F. Arturi , G. Vaccari , F. Gazzotti , E. Bertellini , L. Astore , G. Della Casa , A. Pecchi , A. Barbieri

Objective

To analyze the incidence and impact of the Macklin effect (ME) in critically ill COVID-19 patients and its correlation with pneumothorax (PNX), spontaneous pneumomediastinum (SP), and barotraumatic complications (BC).

Design

Observational single-center study.

Setting

Intensive Care Unit (ICU) of a single Italian hospital.

Patients or participants

Critically ill COVID-19 patients aged ≥18 years, with at least one chest computed tomography (Ch-CT) scan and undergoing mechanical ventilation. Patients with pre-existing PNX, SP, or tracheal lesions at ICU admission were excluded.

Interventions

Retrospective analysis of Ch-CT scans to detect ME.

Main variables of interest

ME incidence, its correlation with barotrauma development and mortality.

Results

Among 138 patients, ME was detected in 5.80% (8 cases) on the first Ch-CT scan and in 10.87% (15 cases) at any time during ICU stay. PNX occurred in 17.39% (24 cases) and subcutaneous emphysema in 14.49% (20 cases), with a total BC incidence of 23.91% (33 cases). ME presence on the first Ch-CT scan was significantly associated with PNX (OR 5.5, p = 0.012), SP (OR 12.77, p < 0.001), and BC (OR 11.44, p = 0.004). ME detection on the first Ch-CT scan showed a Hazard Ratio (HR) of 5.91 (CI 2.41-14.50, p < 0.001) for BC development.

Conclusions

Early ME detection in critically ill COVID-19 patients is crucial, as it is significantly associated with PNX, SP, and BC. Recognizing ME could play a role in improving clinical management and outcomes.

目的分析新冠肺炎危重症患者麦克林效应（Macklin effect， ME）的发生率、影响及其与气胸（PNX）、自发性纵隔气肿（SP）、气压创伤并发症（BC）的相关性。设计：观察性单中心研究。设置意大利一家医院的重症监护室（ICU）。患者或参与者年龄≥18岁，至少进行一次胸部计算机断层扫描（Ch-CT）并接受机械通气的COVID-19危重患者。排除入院时已存在PNX、SP或气管病变的患者。干预措施：Ch-CT扫描检测ME的回顾性分析。感兴趣的主要变量me发病率及其与气压伤发展和死亡率的相关性。结果138例患者中，首次ct扫描ME检出率为5.80%（8例），ICU住院期间任何时间ME检出率为10.87%（15例）。PNX发生率为17.39%（24例），皮下肺气肿发生率为14.49%（20例），BC总发病率为23.91%（33例）。首次Ch-CT扫描时ME的存在与PNX （OR 5.5, p = 0.012）、SP （OR 12.77, p < 0.001）和BC （OR 11.44, p = 0.004）显著相关。首次Ch-CT扫描时ME检测显示BC发展的风险比（HR）为5.91 （CI 2.41-14.50, p < 0.001）。结论危重症患者早期ME检测至关重要，与PNX、SP、BC有显著相关性。认识ME可以在改善临床管理和结果方面发挥作用。

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引用次数: 0

Evaluación preoperatoria de la función cognitiva: idoneidad y resultados 认知功能的术前评估：适宜性和结果

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion

Pub Date : 2025-12-01 DOI: 10.1016/j.redar.2025.501857

B. Tena, A. Fervienza, I. Gracia, N. Fábregas

引用次数: 0

Manejo anestésico de la reparación endovascular del arco aórtico con la prótesis NEXUS TRE™: a propósito de un caso clínico 使用NEXUS TRE™假体进行主弓血管内修复的麻醉管理：以临床为目的

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion

Pub Date : 2025-12-01 DOI: 10.1016/j.redar.2025.501914

J.A. Rodenas-Rubio , J. Guillén-Perales , M. Vintimilla-Izquierdo

Endovascular aortic arch surgery is an evolving field that offers less invasive alternatives to open surgery. The emergence of new devices and their implantation imply new considerations in the management by the anaesthesiologist during the procedure. An example of this is the NEXUS TRE™ stent, designed to preserve the patency of the supra-aortic trunks without the need for extra-anatomic bypass. We present the case of a 75-year-old man diagnosed with an aortic arch aneurysm with accelerated growth and risk of rupture, who underwent endovascular repair of the aortic arch and its 3 branches with the NEXUS TRE™ stent. This is one of the first cases carried out in Europe, specifically in Spain.

血管内主动脉弓手术是一个不断发展的领域，为开放手术提供了侵入性较小的选择。新器械的出现及其植入意味着麻醉医师在手术过程中的管理需要新的考虑。NEXUS TRE™支架就是一个例子，它的设计目的是保持主动脉上干的通畅，而不需要解剖外搭桥。我们报告一例75岁的男性主动脉弓动脉瘤患者，其生长速度加快，有破裂风险，他接受了NEXUS TRE™支架对主动脉弓及其3个分支的血管内修复。这是在欧洲，特别是在西班牙实施的首批病例之一。

引用次数: 0

Dolor neuropático y crónico de nueva aparición en supervivientes de COVID-19 grave: análisis secundario del ensayo PAIN-COVID 严重2019冠状病毒病幸存者的慢性和神经疼痛复发：PAIN- 2019冠状病毒病试验的二次分析

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion

Pub Date : 2025-12-01 DOI: 10.1016/j.redar.2025.501915

A. Ojeda, T. Cuñat, O. Comino-Trinidad, J. Aliaga, M. Arias, A. Calvo

Background

Survivors of critical illnesses, including COVID-19, are at risk of developing Chronic ICU-Related Pain (CIRP) and neuropathic pain (NP). This study evaluates the incidence of CIRP and NP 6 months after hospital discharge and their impact on pain intensity, functional status, and quality of life (QoL).

Methods

We performed an observational prospective cohort analysis based on a secondary analysis of data from the existing PAIN-COVID randomized controlled trial, which included adult survivors of severe COVID-19 admitted to the ICU. CIRP and NP were assessed at 6 months post-discharge using validated scales (Brief Pain Inventory [BPI] and DN4-interview). Propensity score matching was used to control for confounding factors when comparing pain intensity, functional impact, and QoL between groups.

Results

New-onset CIRP was reported by 47.7% of patients. In matched cohorts, patients with CIRP had significantly lower EQ-5D-5L index (0.705 [0.613-0.818]; p< 0.001) and VAS (72 [60–80]; p = 0.019) scores compared to those without pain. NP affected 36.5% of patients. Patients with NP showed higher BPI-intensity (5.3 [2.5–6], p = 0.002) and BPI-interference scores (4.5 [1.5–6.9], p = 0.025). The EQ-5D-5L index (0.68 [0.36-0.81]; p = 0.29) and VAS scores (60 [47.5–85]; p = 0.032) were lower compared to those without NP.

Conclusion

A substantial proportion of COVID-19 ICU survivors develop new-onset CIRP and NP within 6 months after discharge, resulting in significant impairment in QoL.

Trial registration

# NCT04394169, registered on 5/19/2020.

包括COVID-19在内的重症幸存者面临慢性重症监护病房相关疼痛（CIRP）和神经性疼痛（NP）的风险。本研究评估出院后6个月CIRP和NP的发生率及其对疼痛强度、功能状态和生活质量的影响。方法基于对现有PAIN-COVID随机对照试验数据的二次分析，我们进行了一项观察性前瞻性队列分析，该试验包括ICU住院的重症COVID-19成年幸存者。CIRP和NP在出院后6个月使用有效的量表（简短疼痛量表[BPI]和dn4访谈）进行评估。在比较组间疼痛强度、功能影响和生活质量时，采用倾向评分匹配来控制混杂因素。结果新发CIRP占47.7%。在匹配的队列中，与无疼痛的患者相比，CIRP患者的EQ-5D-5L指数（0.705 [0.613-0.818];p< 0.001）和VAS评分（72 [60-80];p = 0.019）显著降低。NP影响36.5%的患者。NP患者的bpi强度（5.3 [2.5-6],p = 0.002）和bpi干扰评分（4.5 [1.5-6.9],p = 0.025）较高。EQ-5D-5L指数（0.68 [0.36-0.81];p = 0.29）和VAS评分（60 [47.5-85];p = 0.032）均低于无NP组。结论COVID-19 ICU存活患者出院后6个月内有相当比例出现新发CIRP和NP，导致生活质量明显下降。试验注册号NCT04394169，于2020年5月19日注册。

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引用次数: 0

Calidad de la formación en anestesia regional ecoguiada en hospitales docentes de Cataluña: una encuesta de opinión de residentes y tutores 加泰罗尼亚教学医院生态指导区域麻醉培训的质量：对住院医师和导师意见的调查

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion

Pub Date : 2025-11-01 DOI: 10.1016/j.redar.2025.501913

C. Barreiros , J. Mejía , I. García-Rojas , X. Sala-Blanch

引用次数: 0

Bloqueo ecoguiado del canal del aductor: ¿puede el abordaje del eje corto oblicuo facilitar la inserción del catéter perineural? Estudio controlado aleatorizado 内收管超声导管阻塞：短斜轴支架能促进神经周围导管的插入吗？随机对照研究

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion

Pub Date : 2025-11-01 DOI: 10.1016/j.redar.2025.501901

M.A.R. Nasr, A. Ahmed, N. Ahmed, S. Soaida, M. Waheeb

Introduction

The transverse short-axis in-plane is the standard approach for ultrasound-guided perineural catheter insertion and threading during adductor canal block (BCA). We hypothesized that the oblique short-axis in-plane approach could simplify and speed up catheter insertion and threading by eliminating some technical difficulties.

Methods

We included 50 patients aged ≥ 18 years, ASA I and II, who were scheduled for unilateral knee arthroscopy under spinal anesthesia. We planned to use BCA with a perineural catheter for postoperative analgesia. After administering spinal anesthesia, the patients were randomly assigned to the oblique (oblique short-axis in-plane approach) or transverse (standard short-axis in-plane approach) groups. The primary endpoint was catheter insertion time. The secondary endpoints were catheter threading difficulty, and incidence of vascular puncture and catheter migration.

Results

The catheter insertion time was significantly shorter in the oblique group vs the transverse group (113.8 ± 49.2 s vs 185.8 ± 46.7 s, respectively, P < .001). Catheter threading was significantly easier in the oblique group, as shown by the lower threading difficulty score compared to the transverse group. Both groups were comparable in terms of the incidence of vascular puncture and catheter migration.

Conclusion

In patients who underwent knee arthroscopy under spinal anesthesia, the oblique short-axis in-plane approach for catheter insertion during BCA was faster and less technically challenging than the standard transverse short-axis in-plane approach.

横向短轴平面内入路是超声引导下内收管阻滞（BCA）术中围神经导管插入和穿线的标准入路。我们假设斜短轴平面内入路可以通过消除一些技术困难来简化和加快导管的插入和穿线。方法纳入50例年龄≥18岁，ASA I和II级的患者，在脊髓麻醉下行单侧膝关节镜检查。我们计划使用BCA配合神经周导管进行术后镇痛。给予脊髓麻醉后，将患者随机分为斜（斜短轴平面内入路）组和横（标准短轴平面内入路）组。主要终点为导管插入时间。次要终点是导管穿线困难、血管穿刺和导管移位的发生率。结果斜置组置管时间明显短于横置组（113.8±49.2 s vs 185.8±46.7 s, P < 001）。斜位组的导管穿线难度评分明显低于横位组。两组在血管穿刺和导管移位的发生率方面具有可比性。结论在脊柱麻醉下行膝关节镜患者行BCA时，斜短轴平面内入路比标准的横向短轴平面内入路更快，技术难度更小。

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引用次数: 0

Nueve pasos clave en anestesia regional: infografía para su adopción clínica 区域麻醉的九个关键步骤：临床应用的信息图

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion

Pub Date : 2025-11-01 DOI: 10.1016/j.redar.2025.501900

P. Galli , H. Labandeyra , G. Irizaga , A. Schwartzmann

引用次数: 0

Programas de mejora de la calidad perioperatoria: se necesita urgentemente una red perioperatoria para promover la educación, la colaboración y la innovación contextual 手术期质量改进方案：迫切需要建立一个手术期网络，以促进教育、合作和环境创新

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion

Pub Date : 2025-11-01 DOI: 10.1016/j.redar.2025.501928

H.D. de Boer, B.M. Biccard, B.R. Martini

引用次数: 0

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