Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Recuperación mejorada tras la cirugía y resultados oncológicos a largo plazo: análisis post hoc del estudio POWER","authors":"J. Ripollés-Melchor ,&nbsp;A. Zorrilla-Vaca ,&nbsp;A. León-Bretscher ,&nbsp;A. Abad-Motos ,&nbsp;P. Galán-Menéndez ,&nbsp;J.L. Muñoz-Rodés ,&nbsp;D. Zapata ,&nbsp;Á. Ramiro-Ruiz ,&nbsp;C. Aldecoa ,&nbsp;V. Molnar ,&nbsp;L. Jordá-Sanz ,&nbsp;A. Cuéllar-Martínez ,&nbsp;H. Berges-Gutiérrez ,&nbsp;A. Landaluce-Olavarria ,&nbsp;R. Fernández-García ,&nbsp;N. Aracil-Escoda ,&nbsp;A.M. Pacual-Bellosta ,&nbsp;M. Ubré-Lorenzo ,&nbsp;M. Logroño-Ejea ,&nbsp;A.B. Serrano Romero ,&nbsp;A. Abad-Gurumeta","doi":"10.1016/j.redar.2025.501926","DOIUrl":"10.1016/j.redar.2025.501926","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Colorectal cancer (CRC) remains a leading cause of cancer-related mortality. While Enhanced Recovery After Surgery (ERAS) programs optimize perioperative care, their effect on oncologic prognosis requires further validation. This study evaluates ERAS adherence and five-year survival through a post-hoc analysis of the POWER Study.</div></div><div><h3>Methods</h3><div>This sub-analysis included 901 patients from 32 hospitals with available five-year follow-up data. Patients undergoing elective CRC resection were stratified based on ERAS adherence (≥<!--> <!-->70%). Primary outcomes included overall survival and recurrence rates, analyzed using Cox proportional hazards models adjusted for clinical variables. Kaplan-Meier curves and subgroup analyses were also performed to assess stage-specific differences.</div></div><div><h3>Results</h3><div>No significant differences were observed in five-year overall survival (ERAS 66% vs. non-ERAS 60%; HR: 1.14, 95% CI: 0.88-1.49; P<!--> <!-->=<!--> <!-->0.32) or recurrence rates (ERAS 25% vs. non-ERAS 25%; HR: 0.91, 95% CI: 0.68-1.22; P<!--> <!-->=<!--> <!-->0.53). Kaplan-Meier curves showed overlapping survival trajectories, and subgroup analyses confirmed no stage-specific disparities. While ERAS promotes early postoperative recovery and facilitates timely adjuvant therapy initiation, its effect on long-term oncologic outcomes remains inconclusive.</div></div><div><h3>Conclusions</h3><div>These findings support ERAS as a safe perioperative strategy that enhances short-term recovery without compromising oncologic safety. However, limitations such as the post-hoc design and incomplete long-term data warrant further research. Future studies should investigate ERAS's impact on perioperative stress, immune function, and recurrence prevention to better elucidate its role in long-term CRC outcomes.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501926"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398371","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":"Comparación entre el efecto de una única inyección de morfina neuroaxial y el bloqueo en el plano del músculo erector de la columna en la calidad de la recuperación (QoR-15) tras cirugías gastrointestinales mayores abiertas: ensayo aleatorizado prospectivo","authors":"A. Choudhary ,&nbsp;S. Singh ,&nbsp;V. Kumar ,&nbsp;H. Kumar ,&nbsp;K. Parasar","doi":"10.1016/j.redar.2025.501925","DOIUrl":"10.1016/j.redar.2025.501925","url":null,"abstract":"<div><h3>Background</h3><div>Assessing a patient's quality of recovery after major surgery is crucial. This study aims to compare the effect of neuraxial morphine and bilateral erector spinae plane block on quality of recovery in the first 48 hours postoperative in patients undergoing open upper abdominal surgeries.</div></div><div><h3>Methods</h3><div>This prospective, triple-arm randomized study was conducted to compare the effect of neuraxial morphine (intrathecal morphine, thoracic epidural) with erector spinae plane block on postoperative recovery. The primary outcome was the Quality of Recovery-15 (QoR-15) score at 24 h. Secondary objectives were pain severity using the numerical rating scale (NRS) score during 24 h after surgery, time to first rescue analgesia, and adverse effects.</div></div><div><h3>Results</h3><div>We enrolled 117 adult patients undergoing open upper abdominal surgeries who were randomly allocated to the intrathecal morphine (ITM) group, thoracic epidural (TEM) group, or bilateral low volume erector spinae plane block (LV-ESPB) group. The mean ± standard deviation 24-h QoR-15 scores were comparable in the ITM [115.83 ± 4.0] and TEM [113.51 ± 4.36] groups; however, they were significantly decreased in the LV-ESPB group [104.58 ± 4.05] (p value &lt; 0.001). All time points showed equivalent NRS scores except at 24 hours (p-value - 0.002) between the three groups. The time to first rescue analgesia was comparable in all three groups. The incidence of nausea and pruritus was statistically significant in the ITM group compared to the TEM and LV-ESPB groups (p-value &lt; 0.001 and 0.019, respectively).</div></div><div><h3>Conclusions</h3><div>The study demonstrated that neuraxial morphine achieved better quality of recovery in the first 24 hours after major abdominal surgery as compared to bilateral erector spinae plane block.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501925"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398374","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":"Toxina botulínica perineural en el tratamiento de la cefalea postraumática. Caso clínico","authors":"L. Arce Gálvez ,&nbsp;J.M. Mancera Álzate","doi":"10.1016/j.redar.2025.501903","DOIUrl":"10.1016/j.redar.2025.501903","url":null,"abstract":"<div><div>Post-traumatic headache is a common condition that can be managed with pharmacologic interventions or analgesic procedures; however, most evidence is derived from patients with mild trauma, leaving a large gap with regard to patients with moderate or severe trauma who present complex pain. Botulinum toxin plays an increasingly important role in pain management. This neurotoxin acts on different receptors, ranging from TRPV1 (transient receptor potential vanilloid type<!--> <!-->1) to CGRP (calcitonin gene-related peptide). This is the first case report of the use of perineural botulinum toxin in a patient with moderate post-traumatic headache who responded poorly to standard interventional measures.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501903"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398366","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":"Impacto de los rellenos faciales en la valoración de la vía aérea","authors":"C. Juliá-Romero ,&nbsp;B. Simón-Rivero ,&nbsp;L. Ceresuela-Dionís ,&nbsp;S. de Benito-Mendieta","doi":"10.1016/j.redar.2025.501802","DOIUrl":"10.1016/j.redar.2025.501802","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501802"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398364","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":"Recomendaciones basadas en la opinión de expertos promovidas por GTIPO-SEDAR para optimizar el abordaje terapéutico de la candidiasis intraabdominal","authors":"E. Maseda ,&nbsp;T. Peláez ,&nbsp;G. Aguilar ,&nbsp;I. Martín Loeches ,&nbsp;A. Benítez-Cano ,&nbsp;A. Rodríguez ,&nbsp;R. Zaragoza ,&nbsp;J. Guinea ,&nbsp;C. Aldecoa ,&nbsp;A. Suárez de la Rica","doi":"10.1016/j.redar.2025.501916","DOIUrl":"10.1016/j.redar.2025.501916","url":null,"abstract":"<div><div>Intra-abdominal candidiasis (IAC) is a highly prevalent infectious syndrome and a significant cause of mortality in intensive care units. The Working Group on Perioperative Infections of the Spanish Society of Anesthesiology, Resuscitation, and Pain Management has promoted the development of recommendations based on the experience of a multidisciplinary panel of experts from various medical specialties, aiming to optimize the diagnosis and treatment of severe infectious processes such as IAC. These recommendations have been formulated through a rigorous critical appraisal of the currently available scientific evidence. This document provides guidance for optimizing the therapeutic approach to IAC, incorporating the latest findings in microbiology, recent therapeutic advances, pharmacokinetic and pharmacodynamic considerations in critically ill patients with IAC, special therapeutic considerations for patients undergoing extracorporeal membrane oxygenation and continuous renal replacement therapies, the appropriateness of empirical versus targeted therapy, and strategies for improving and reducing the duration of treatment.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501916"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398365","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":"Abordaje abierto frente a abordaje ecográfico para el bloqueo profundo del plano del músculo serrato anterior para analgesia postoperatoria tras mastectomía radical modificada: ensayo aleatorizado controlado","authors":"M. Mohammed Alseoudy ,&nbsp;M. Abd el-Ghaffar Saleh ,&nbsp;S. Saleh Elbalka ,&nbsp;T. Elmetwally Farahat ,&nbsp;D. Abdellatif Elebedy ,&nbsp;S. Elsayed Ahmed","doi":"10.1016/j.redar.2025.501902","DOIUrl":"10.1016/j.redar.2025.501902","url":null,"abstract":"<div><h3>Background and aims</h3><div>Ultrasound-guided deep serratus anterior plane (SAP) block has recently gained popularity as an analgesic technique in breast surgery. However, the effectiveness of ultrasound depends largely on the quality of the equipment used, and the technique can be complicated by patient-related factors such as obesity. We hypothesized that the simpler open approach to deep SAP block would be non-inferior to the ultrasound-guided approach in providing analgesia for modified radical mastectomy.</div></div><div><h3>Method</h3><div>A non-inferiority, randomized controlled study was performed in 100 patients aged 18-60 years who underwent modified radical mastectomy. In the open approach group (n<!--> <!-->=<!--> <!-->50), 30<!--> <!-->ml of 0.25% bupivacaine was injected deep to the serratus anterior muscle after breast resection and rib palpation. In the ultrasound-guided group (n<!--> <!-->=<!--> <!-->50), 30<!--> <!-->ml of 0.25% bupivacaine was injected deep to the serratus anterior muscle under ultrasound guidance before the skin incision. The primary outcome was total morphine consumption in the first 24 postoperative hours. Secondary outcome measures included time to first request for rescue analgesia (duration of SAP block), postoperative visual analogue scale score, and the incidence of adverse effects.</div></div><div><h3>Results</h3><div>Median (interquartile range) morphine requirement in the first 24<!--> <!-->h was similar in both groups (P<!--> <!-->=<!--> <!-->0.81), and the time to first request for analgesia was also similar (P<!--> <!-->=<!--> <!-->0.81). Evaluation of visual analogue scale scores during the initial 24<!--> <!-->h after surgery showed no statistically significant differences between groups (P<!--> <!-->&gt;<!--> <!-->0.05), except at 4 postoperative hours, when the score was significantly higher in the ultrasound group (P<!--> <!-->&lt;<!--> <!-->0.001). No complications were observed in either group.</div></div><div><h3>Conclusion</h3><div>The open approach to deep SAP block is comparable to the ultrasound-guided approach in providing postoperative analgesia in female patients undergoing modified radical mastectomy.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501902"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398369","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":"Documento de consenso para la solicitud de pruebas de coagulación preoperatorias","authors":"J.L. Jover Pinillos ,&nbsp;R. Ferrandis Comes ,&nbsp;J.V. Llau Pitarch ,&nbsp;D. Zamudio Penko ,&nbsp;M. Basora Macaya ,&nbsp;M.J. Colomina Soler ,&nbsp;A. Abad Gurumeta ,&nbsp;J. García Fernández","doi":"10.1016/j.redar.2025.501931","DOIUrl":"10.1016/j.redar.2025.501931","url":null,"abstract":"<div><h3>Introduction</h3><div>Standard pre-operative coagulation tests have shown limited ability to detect haemostatic abnormalities, yet they continue to be ordered routinely. Clear guidance is lacking in our setting. We therefore sought to develop consensus recommendations on their indication using a Delphi methodology.</div></div><div><h3>Material and methods</h3><div>A three-round, online, multicentre Delphi study was conducted. Ten expert anaesthesiologists convened and recruited colleagues until the working group comprised 59 anaesthesiologists; 50 completed all rounds. The panel rated 46 statements on a 1-9 Likert scale. Consensus was defined in the third round as ≥<!--> <!-->70% of ratings ≥<!--> <!-->7. Accepted statements were classified as weak (70-79%), moderate (80-89%) or strong (90-100%) agreement.</div></div><div><h3>Results</h3><div>Twenty-nine statements were accepted, synthesised into 21 and grouped into 6 categories: general indication, patient risk factors, procedure characteristics, global assessment, paediatric patients, and special cases. Agreement was strong for 14 statements, moderate for 5, and weak for 2. Key recommendations were: (1)<!--> <!-->avoid universal testing; (2)<!--> <!-->base testing on medical history, standardised bleeding-risk questionnaires and specific risk factors (anticoagulation, liver disease, renal insufficiency, haematopoietic disorders); (3)<!--> <!-->order tests before high-complexity or high-bleeding-risk procedures; and (4)<!--> <!-->use specific assays in patients receiving direct oral anticoagulants.</div></div><div><h3>Conclusions</h3><div>Pre-operative coagulation testing should be individualised according to the patient's haemostatic risk profile and the haemorrhagic risk of the planned procedure.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501931"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398323","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":"Efectos de la anestesia en la función cognitiva en ratones jóvenes y mayores: rol de la expresión de c-Fos en la excitabilidad neuronal del hipocampo","authors":"Y. Li ,&nbsp;Z. Jin ,&nbsp;L. Beiping ,&nbsp;A. Xiaolei","doi":"10.1016/j.redar.2025.501904","DOIUrl":"10.1016/j.redar.2025.501904","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the effects of anaesthesia and surgical procedures on the cognitive function of both young and aged mice. It will also explore the role and mechanisms of c-Fos expression in altering hippocampal neuron excitability and its relationship with perioperative neurocognitive disorders in mice.</div></div><div><h3>Methods</h3><div>In this study, we used a murine laparotomy model to assess cognitive behavioural changes in both young and aged mice at 1, 3, and 7<!--> <!-->days post-surgery. We used immunofluorescence techniques to evaluate c-Fos expression in the dorsal hippocampus of aged mice following laparotomy. We also used a chemical genetic approach, injecting a virus into the dorsal hippocampus to modulate neuronal excitability, and subsequently analysed changes in object location memory (OLM) and temporal order memory (TOM). Furthermore, we used Golgi staining to observe the density of dendritic spines in the dorsal hippocampal region of aged mice following anaesthesia and viral injection.</div></div><div><h3>Results</h3><div>No significant cognitive differences were observed between young mice and aged mice administered anaesthesia alone, compared to their respective control groups. However, only the aged mice that underwent surgery displayed significant deficits in OLM and T-maze (TOM) tasks one day post-surgery (one-way ANOVA: OLM: F<!--> <!-->=<!--> <!-->27.507, <em>P</em> <!-->&lt;<!--> <!-->.001; TOM: F<!--> <!-->=<!--> <!-->12.196, <em>P</em> <!-->&lt;<!--> <!-->.001), while the OLM recognition index showed no significant change (one-way ANOVA: F<!--> <!-->=<!--> <!-->.057, <em>P</em> <!-->=<!--> <!-->.982). Furthermore, c-Fos positive neurons in the dorsal hippocampus of aged mice decreased significantly one day after surgery (one-way ANOVA: F<!--> <!-->=<!--> <!-->.057, <em>P</em> <!-->=<!--> <!-->.0048). The application of a chemical-genetic method to enhance the excitability of neurons in the dorsal hippocampus effectively reversed surgery-induced cognitive impairment (one-way ANOVA: OLM: F<!--> <!-->=<!--> <!-->.032, <em>P</em> <!-->=<!--> <!-->.021; TOM: F<!--> <!-->=<!--> <!-->.024, <em>P</em> <!-->=<!--> <!-->.019) and depletion of dendritic spine density (<em>P</em> <!-->&lt;<!--> <!-->.01).</div></div><div><h3>Conclusion</h3><div>Temporal and spatial memory functions are impaired in aged mice following surgery, while object recognition memory remains unaffected. Surgical procedures result in a decrease in the number of c-Fos positive neurons and neuronal excitability in the dorsal hippocampus of aged mice. Furthermore, enhancing neuronal excitability in the dorsal hippocampus alleviates postoperative cognitive impairment in aged mice. Additionally, increasing neuronal excitability in the dorsal hippocampus can counteract the surgery-induced reduction in dendritic spine density.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501904"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398372","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":"Delirium postoperatorio: de la evidencia internacional a la práctica en España. Una asignatura pendiente","authors":"E.M. Aldana ,&nbsp;C. Aldecoa","doi":"10.1016/j.redar.2025.501920","DOIUrl":"10.1016/j.redar.2025.501920","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501920"},"PeriodicalIF":0.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722116","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":"Índices Doppler de la arteria cubital, un nuevo predictor emergente de la preservación segmentaria del cúbito después del bloqueo supraclavicular: un estudio observacional prospectivo","authors":"M. Adolf Helmy,&nbsp;M. Medhat Megalaa,&nbsp;H. Mohamed Mamdouh,&nbsp;I.A. Ismail,&nbsp;L. Magdy Milad","doi":"10.1016/j.redar.2025.501899","DOIUrl":"10.1016/j.redar.2025.501899","url":null,"abstract":"<div><h3>Background</h3><div>Supraclavicular brachial plexus block offers several advantages over general anesthesia, yet segmental ulnar sparing is one of the procedure's key drawbacks. Many parameters were proposed to ascertain segmental ulnar sparing, including thermal imaging and perfusion index. However, none proved optimal; therefore, we aimed to evaluate ulnar artery Doppler indices as a potential predictor of segmental ulnar sparing.</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted at a tertiary center. To obtain a study power of 90% and an alpha error of 0.05, a minimum sample size of 62 patients was required, with a minimum of 11 patients exhibiting segmental ulnar sparing. Adult patients who received supraclavicular brachial plexus block for hand surgery were included. Each dermatome was assessed in terms of motor and sensory function. An experienced operator performed Doppler examinations at baseline, 10-, 20-, and 30<!--> <!-->minutes following block administration. The primary outcome was the accuracy of the change in PI (ΔPI) in predicting segmental ulnar sparing. Other outcomes included the change in resistive index (ΔRI) and the change in waveform morphology (ΔM) to predict segmental ulnar sparing</div></div><div><h3>Results</h3><div>Of the 81 patients assessed for eligibility, 15 were excluded, leaving sixty-six in the final analysis. Eleven of the 66 individuals showed segmental ulnar sparing. ΔPI and ΔRI have been identified as accurate predictors of segmental ulnar sparing with best cut-off values of &lt;<!--> <!-->8.8% and 12%, respectively. Additionally, ulnar artery Doppler morphological changes from triphasic pattern to a monophasic wave can rule out segmental ulnar sparing with a 100% negative predictive value.</div></div><div><h3>Conclusion</h3><div>In adult patients undergoing hand surgery using supraclavicular brachial plexus block, Changes of Doppler indices, namely ΔPI, ΔRI, and ΔM, showed good accuracy in predicting segmental ulna preservation. However, the generalizability of our findings is limited by being a single-center study with a relatively small sample size.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501899"},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134821","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}