Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Factores asociados a la dehiscencia de anastomosis postoperatoria y comparación de 4 escalas de predicción en cirugía colorrectal","authors":"J.M. Nieves-Alonso,&nbsp;L.A. Gómez Arredondo,&nbsp;P. Maestre Serantes,&nbsp;C. Martín Martín,&nbsp;F. Guitart de la Lastra,&nbsp;F. Ramasco Rueda","doi":"10.1016/j.redar.2025.501852","DOIUrl":"10.1016/j.redar.2025.501852","url":null,"abstract":"<div><h3>Introduction</h3><div>Anastomotic leakage is a serious post-colorectal surgery complication, and has an incidence ranging from 2.8% to 30%. Identifying risk factors and evaluating prediction scores could optimize perioperative management. This study analyses factors associated with dehiscence and compares the predictive capacity of four scales: ASA, CCI, RCRI and AUB-HAS2.</div></div><div><h3>Methods</h3><div>Retrospective observational study in 182 patients undergoing colorectal surgery with anastomosis in a Spanish tertiary hospital (2018-2020). Clinical and perioperative data were collected, and the ASA, CCI, RCRI and AUB-HAS2 scores were calculated. Risk factors were analysed using multivariate logistic regression, and predictive capacity was assessed with ROC curves.</div></div><div><h3>Results</h3><div>Leakage occurred in 13.2% of cases. In the multivariate analysis, heart failure (OR: 4.14; 95% CI: 1.14-13.77) and laparotomy (OR: 2.67; 95% CI: 1.07-6.60) were significantly associated with dehiscence. None of the scales predicted this complication. The AUB-HAS2 and CCI scales were associated with 30-day mortality (AUC: 0.81 and 0.74, respectively), and the CCI predicted the need for organ support (AUC: 0.71).</div></div><div><h3>Conclusion</h3><div>Heart failure and laparotomy are independent risk factors for anastomotic leakage. Although none of the scales predicted this complication, the AUB-HAS2 and CCI were useful in stratifying postoperative mortality. This highlights the importance of personalized assessment.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501852"},"PeriodicalIF":0.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722120","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 de los bloqueos del plano de los músculos serrato y erector de la columna para analgesia postoperatoria en cirugía unilateral de la mama","authors":"K. Şahin ,&nbsp;C. Sayman ,&nbsp;S. Kına ,&nbsp;A. Surhan Çınar","doi":"10.1016/j.redar.2025.501830","DOIUrl":"10.1016/j.redar.2025.501830","url":null,"abstract":"<div><h3>Objective</h3><div>The use of interfascial plane blocks for postoperative analgesia is becoming more widespread because they are easier to perform and have fewer complications. This prospective, single-blind, randomized controlled study compares the efficacy of serratus plane block (SPB) and erector spinae plane block (ESPB) for postoperative analgesia in patients undergoing unilateral breast surgery.</div></div><div><h3>Methods</h3><div>Seventy-four ASA I-II patients aged 18-65 years who underwent elective unilateral breast surgery were included in the study. After exclusion, 70 patients were randomized to receive SPB (n<!--> <!-->=<!--> <!-->35) or ESPB (n<!--> <!-->=<!--> <!-->35). In both groups, nerve blocks were administered under ultrasound guidance with 25<!--> <!-->mL of 0.25% bupivacaine. Postoperative pain (assessed using the visual analogue scale [EVA]), duration of analgesia, tramadol consumption, and incidence of complications were recorded.</div></div><div><h3>Results</h3><div>There were no significant differences in EVA scores between groups. However, duration of analgesia was significantly higher in the ESPB group (395.6<!--> <!-->± 141.9<!--> <!-->minutes) vs the SPB group (290.3<!--> <!-->±<!--> <!-->148.3<!--> <!-->minutes) (p<!--> <!-->=<!--> <!-->0.003). Total tramadol consumption over 24<!--> <!-->hours was similar between groups: 70.9<!--> <!-->±<!--> <!-->48.6<!--> <!-->mg in the SPB group and 70.3<!--> <!-->±<!--> <!-->50.5<!--> <!-->mg in the ESPB group. Minimal postoperative complications, including nausea and vomiting, were noted with no significant difference between groups.</div></div><div><h3>Conclusion</h3><div>Both SPB and ESPB were safe and provided similar postoperative analgesia in patients undergoing unilateral breast surgery. ESPB provides longer lasting analgesia, and therefore improves patient comfort in the early postoperative period.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501830"},"PeriodicalIF":0.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134790","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":"Guía clínica y plan estratégico para la prevención, el diagnóstico y el tratamiento del delirium: Proyecto Delirium Zero","authors":"O. de la Varga-Martínez ,&nbsp;R. Badenes ,&nbsp;C. Gordaliza ,&nbsp;S. de Miguel Manso ,&nbsp;G.E. Landázuri Castillo ,&nbsp;C. Armenteros Aragon ,&nbsp;M. Fernández Castro ,&nbsp;A.B. Martin Santos ,&nbsp;R. Lopez Herrero ,&nbsp;R. Navarro Pérez ,&nbsp;A. Abad Gurumeta ,&nbsp;M. Varela Duran ,&nbsp;M. Heredia Rodriguez ,&nbsp;E. Tamayo Gómez ,&nbsp;revisores externos","doi":"10.1016/j.redar.2025.501805","DOIUrl":"10.1016/j.redar.2025.501805","url":null,"abstract":"<div><div>The aim of this clinical practice guideline is to provide a rationale for the implementation of the Zero Delirium Project (ZDP) - a series of recommendations for patients in special critical care units (SCCU). The recommendations were developed by a group of anaesthesiologists from around Spain, and were reviewed by the Scientific Committee of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy.</div><div>Delirium is an acute, fluctuating, multifactorial syndrome characterised by inattention, disorganised thinking, and an altered level of consciousness. It may affect up to 56% in patients during their stay in critical care, and is important because many SCCUs have not yet introduced routine delirium screening, treatment and prevention strategies. Staff that are able to recognise and diagnose delirium can prevent it, treat it and reduce its incidence, which in turn reduces morbidity, mortality and costs. The ZDP was created with this aim in mind.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501805"},"PeriodicalIF":0.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721974","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 la supervisión y la gestión guiada por el índice de predicción de la hipotensión frente a la hemodinámica estándar en la reducción de la hipotensión intraoperatoria","authors":"J. Ripollés-Melchor ,&nbsp;P. Fernández-Valdés-Bango ,&nbsp;D. García-López ,&nbsp;M. Olvera-García ,&nbsp;J.L. Tomé-Roca ,&nbsp;C.A. Vargas-Berenjeno ,&nbsp;A. Ruiz-Escobar ,&nbsp;A.B. Adell-Pérez ,&nbsp;L. Carrasco-Sánchez ,&nbsp;A. Abad-Gurumeta ,&nbsp;J.V. Lorente ,&nbsp;A.V. Espinosa ,&nbsp;I. Jiménez-López ,&nbsp;M.A. Valbuena-Bueno ,&nbsp;M.I. Monge-García","doi":"10.1016/j.redar.2025.501803","DOIUrl":"10.1016/j.redar.2025.501803","url":null,"abstract":"<div><h3>Introduction</h3><div>Intraoperative hypotension (IOH) is a commonly observed phenomenon during major abdominal surgery. The severity and duration of IOH have been identified as crucial factors in the development of these complications.</div></div><div><h3>Methods</h3><div>The study compares two groups of adult patients undergoing major abdominal surgery: one group received standard hemodynamic management using the Edwards Flotrac device, while the second group received hypotension prediction index duration, and severity of intraoperative hypotension in high-risk patients (HPI)-guided hemodynamic management, with anesthesiologists trained via a structured proctoring program. We retrospective analized prospectively gathered anonymized data from 6 Spanish centers during 2021-2022. The primary outcome measure was the time-weighted average of mean arterial pressure &lt;<!--> <!-->65<!--> <!-->mmHg (MAP) during surgery (TWA MAP 65<!--> <!-->mmHg). The secondary outcome measures included incidence of hypotensive episodes, total time with hypotension, and percentage of time spent in hypotension during surgery.</div></div><div><h3>Results</h3><div>A total of 607 patients were analyzed, 270 in the pre-proctoring group vs 337 in the post-proctoring group. The median TWA MAP 65<!--> <!-->mmHg was 0.09<!--> <!-->mmHg (interquartile range [IQR]: 0.00-0.31<!--> <!-->mm Hg) post-proctoring group vs 0.37<!--> <!-->mmHg (IQR: 0.08-1.01<!--> <!-->mm Hg) in the pre-proctoring group, for a median difference of 0.19<!--> <!-->mmHg (95%<!--> <!-->CI: 0.13-0.27<!--> <!-->mmHg; <em>P</em> <!-->&lt;.001), whereas the median TWA MAP &lt;<!--> <!-->55<!--> <!-->mmHg was 0.00<!--> <!-->mmHg (IQR: 0.00-0.01<!--> <!-->mmHg) post-proctoring group vs 0.00<!--> <!-->mmHg (IQR: 0.00-0.07<!--> <!-->mm Hg) in the pre-proctoring group, 0<!--> <!-->mmHg (95%<!--> <!-->CI: 0.0-0.02<!--> <!-->mm Hg; <em>P</em> <!-->&lt;.001).</div></div><div><h3>Conclusions</h3><div>A structured program in hemodynamic training based on the intraoperative use of the hemodynamic prediction index decreases the incidence.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501803"},"PeriodicalIF":0.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134782","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":"La anemia postoperatoria está asociada a malos resultados postoperatorios a largo plazo tras la cirugía oncológica colorrectal electiva dentro de una ruta ERAS","authors":"J. Ripollés-Melchor ,&nbsp;A. Abad-Motos ,&nbsp;M.L. Fuenmayor Valera ,&nbsp;A. Ruiz-Escobar ,&nbsp;A. Abad-Gurumeta ,&nbsp;G. Paseiro-Crespo ,&nbsp;P. Fernández-Valdés-Bango ,&nbsp;A. León-Bretscher ,&nbsp;P. Soto-García ,&nbsp;C. Jericó-Alba ,&nbsp;J.A. García-Erce","doi":"10.1016/j.redar.2024.501724","DOIUrl":"10.1016/j.redar.2024.501724","url":null,"abstract":"<div><h3>Background</h3><div>Anaemia is an independent risk factor for poor perioperative outcomes after major abdominal surgery, and is associated with an increased risk of 30-day postoperative mortality after noncardiac surgery.</div></div><div><h3>Objective</h3><div>To investigate the frequency of postoperative anaemia and short- and long-term survival after colorectal oncologic surgery at a centre with a well-established Enhanced Recovery After Surgery (ERAS) program.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of all patients undergoing elective colorectal oncologic surgery within an ERAS pathway at our institution between 2013 and 2017. Overall survival was calculated with the Kaplan-Meier log rank method and Cox proportional hazard regression based on anaemia at hospital discharge.</div></div><div><h3>Results</h3><div>A total of 680 patients were included. Patients with anaemia at discharge showed a lower overall survival at 5 years (53.9% vs. 44%, p 0.05). Patients who were anaemic at discharge had a lower 5-year overall survival (hazard ratio [HR] 95% CI 2.663 [1.619-4.379], p<!--> <!-->&lt;<!--> <!-->0.001). Kaplan-Meier survival and Cox regression proportional hazard survival for overall survival in the combined preoperative, postoperative, and RBC transfusion model were 1.55 (1.038 2.318) p<!--> <!-->=<!--> <!-->0.032.</div></div><div><h3>Conclusions</h3><div>The combined prognostic value of preoperative anaemia, postoperative anaemia, and blood transfusion created a 40.7% higher risk of not surviving 5 years.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 5","pages":"Article 501724"},"PeriodicalIF":0.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882052","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":"¿Lecciones de historia para un futuro incierto? Anestesiología y reanimación durante el conflicto de Ifni-Sahara (1957-1958)","authors":"R. Navarro-Suay ,&nbsp;L.E. Togores-Sánchez ,&nbsp;R. García-Cañas ,&nbsp;F. Gilsanz-Rodríguez","doi":"10.1016/j.redar.2024.07.002","DOIUrl":"10.1016/j.redar.2024.07.002","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 101648"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792831","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":"Búsqueda en la literatura para la toma de decisiones relativa a la gestión sanitaria sobre cómo incrementar la productividad realizando más casos quirúrgicos en el mismo tiempo asignado","authors":"F. Dexter ,&nbsp;M.Á. Gómez-Ríos ,&nbsp;R.H. Epstein","doi":"10.1016/j.redar.2024.501656","DOIUrl":"10.1016/j.redar.2024.501656","url":null,"abstract":"<div><div>This report shows how the results of a literature search for studies on healthcare management decision-making can help anaesthesiologists improve operating room (OR) turnover. The Scopus database was searched to obtain relevant studies on increasing surgery turnover. References and citations were then examined. The search identified strategies to reduce OR downtime time, facilitate overlapping surgeries, and optimize OR scheduling. Key findings show that reducing anaesthesia-controlled times alone is insufficient to reliably add extra surgical cases within an 8-hour workday. Instead, significant productivity gains are achieved by managing OR turnover times, using induction rooms, and revising workflows to maximize efficiency. Studies show that overlapping surgeries and strategic use of adjacent spaces can significantly increase the number of surgical cases performed daily. Most surgical growth is driven by accommodating low caseload surgeons across multiple specialties. Facilitating OR time access for these surgeons through flexible scheduling and re-sequencing of cases is crucial. Additionally, anaesthesiologists should be engaged in daily OR scheduling and case sequencing, particularly within 2 days of surgery. The dual goals are to increase OR utilization and reduce patient wait times. These results from the management case report underscores the importance of evidence-based OR management practices and proactive involvement of anaesthesiologists in scheduling decisions to enhance surgical turnover.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501656"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792829","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":"Elevación hemidiafragmática y colapso cardiovascular","authors":"E. Soto Garrucho,&nbsp;F. Federero Martínez,&nbsp;F. Polonio Enríquez","doi":"10.1016/j.redar.2024.05.001","DOIUrl":"10.1016/j.redar.2024.05.001","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 101637"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792832","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":"La vía aérea y el inconformismo hacia la excelencia","authors":"M.A. Gómez-Ríos ,&nbsp;A.A.J. Van Zundert ,&nbsp;M.A. Fernández-Vaquero","doi":"10.1016/j.redar.2025.501733","DOIUrl":"10.1016/j.redar.2025.501733","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501733"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792181","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":"Catéter intratecal tras punción dural en pacientes obstétricas: Seguridad y efectividad en la reducción de la cefalea post punción dural","authors":"G. Moreno Giménez,&nbsp;M.C. Melo Cruz,&nbsp;M. Ferrándiz Mach,&nbsp;S. Sabaté Tenas","doi":"10.1016/j.redar.2024.501671","DOIUrl":"10.1016/j.redar.2024.501671","url":null,"abstract":"<div><h3>Background</h3><div>Post-dural puncture headache (PDPH) after an accidental dural puncture (ADP) is a common complication in obstetric analgesia. It has been proposed that inserting an intrathecal catheter (ITC) after an ADP may reduce PDPH incidence and the need for therapeutic epidural blood patch (EBP). Our primary objective was to assess if the insertion of an ITC after an ADP reduces the incidence of PDPH in obstetric patients. Secondary objectives included evaluating EBP requirements and ITC-related complications.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of all obstetric patients with a documented ADP during their labor analgesia between January 2018 to December 2022. Data from the patients in whom an ITC was inserted and those with a repeated epidural were compared.</div></div><div><h3>Results</h3><div>Over our 5-year study period, 35 cases of ADP were documented. Of these, 16 patients (45.7%) received an ITC for 24<!--> <!-->hours, while 19 (54.3%) underwent epidural re-siting. No significant difference was observed in PDPH incidence between ITC and re-sited epidural groups (62.5% vs 68.4%; RR: 0.84; <em>P</em> <!-->=<!--> <!-->.713), nor in EBP requirement (18.8% vs 31.6%; RR: 0.84; <em>P</em> <!-->=<!--> <!-->.387). Follow-up duration did not differ significantly between groups and no ITC-related complications were reported within 1<!--> <!-->month.</div></div><div><h3>Conclusions</h3><div>Our findings align with previously reported literature, indicating a trend favoring ITC utilization. In addition to the potential benefit of reducing PDPH incidence, their use is safe and provides quality analgesia with rapid onset.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501671"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792182","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}