Revista espanola de anestesiologia y reanimacion最新文献

英文中文

Tracheal intubation with videolaryngoscopy: Bridging the language gap 视频喉镜下气管插管：弥合语言差距。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-06-01 DOI: 10.1016/j.redare.2025.501676

M.A. Fernández-Vaquero , A.A.J. van Zundert , M.A. Gómez-Ríos

引用次数: 0

Estimation of minimum effective volume 90% (MEV90) of 0.5% Ropivacaine® in ultrasound-guided interscalene nerve block for postoperative analgesia in arthroscopic shoulder surgery: A prospective observational dose finding study and assessment of diaprhagmatic function 超声引导斜角肌间神经阻滞用于关节镜肩关节手术术后镇痛的0.5%罗哌卡因®最小有效容积90% （MEV90）的估计：一项前瞻性观察性剂量发现研究和膈肌功能评估。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-06-01 DOI: 10.1016/j.redare.2025.501731

B. Moreno , V. Domingo , M. Granell , J.M. Palanca , S. Selfa

Background and objectives

Ultrasound-guided ISB is the most widely-used nerve block in upper limb surgery. The aim of this study was to determine the MEV90 of 0.5% ropivacaine in ISB for analgesia in arthroscopic shoulder surgery.

Methodology

Double-blind observational post-authorization study of a medicinal product for human use. Thirty-two ASA I-III patients aged between 18 and 75 years undergoing arthroscopic shoulder surgery were recruited. We used the Dixon up-down method, whereby the dose is increased or decreased by 1 ml depending on the failure or success of the block. The initial dose was 20 ml of 0.5% ropivacaine. The study was stopped after achieving the minimum 5 negative-positive deflections. Secondary variables were the duration of the block, total analgesia consumption over the first 24 h, and incidence of DP.

Results

The effective LA dose for postoperative analgesia in arthroscopic shoulder surgery was 6.8 ml in 50% of patients (MEV50) (90% CI 6.234–7.465) and 7.733 ml in 90% of patients (MEV90) (90% CI 7.393–9.109). Median sensory block duration was 772.5 min. The incidence of partial and total DP in QB was 34% and 41%, respectively.

Conclusion

A dose of 7.733 ml of 0.5% ropivacaine provides effective postoperative analgesia in arthroscopic shoulder surgery in 90% of patients. This lower dose reduces the likelihood of side effects.

背景与目的：超声引导下的ISB是上肢手术中应用最广泛的神经阻滞。本研究的目的是确定0.5%罗哌卡因在ISB中用于关节镜肩关节手术镇痛的MEV90。方法学：一种人用药品授权后的双盲观察性研究。我们招募了32名年龄在18 - 75岁之间接受肩关节镜手术的ASA I-III型患者。我们采用Dixon上下法，根据阻滞的失败或成功，剂量增加或减少1ml。初始剂量为20ml 0.5%罗哌卡因。在达到最小5个负-正偏转后停止研究。次要变量是阻滞的持续时间，前24小时的总镇痛消耗和DP的发生率。结果：肩关节镜手术患者术后镇痛的有效剂量为6.8 ml， 50%的患者（MEV50）（90% CI 6.234-7.465）， 90%的患者（MEV90）（90% CI 7.393-9.109）。中位感觉阻滞持续时间为772.5分钟。QB部分DP和全部DP的发生率分别为34%和41%。结论：7.733 ml 0.5%罗哌卡因可为90%的肩关节镜手术患者提供有效的术后镇痛。这种较低的剂量减少了副作用的可能性。

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引用次数: 0

Application of generative artificial intelligence chatbots in the field of anesthesia 生成式人工智能聊天机器人在麻醉领域的应用。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-06-01 DOI: 10.1016/j.redare.2025.501667

A. Barroso , R. Casans

引用次数: 0

Tracheal rupture resulting from superinfected aortic intramural hematoma in ascending aortic prosthesis 升主动脉假体超强感染主动脉壁内血肿导致气管破裂。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-06-01 DOI: 10.1016/j.redare.2025.101646

E. Pereda González, A. Cervera Puchades, M.J. Hernández-Cádiz, J. Moreno Pachón, J. de Andrés Ibáñez

引用次数: 0

Should the definition of neuropathic pain be updated? 神经性疼痛的定义应该更新吗？

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-06-01 DOI: 10.1016/j.redare.2025.501751

A. Alcántara Montero

引用次数: 0

Effect of caffeine on respiratory rate, recovery time, and brain wave activity during emergence from sevoflurane anaesthesia in rats 咖啡因对七氟烷麻醉后大鼠呼吸频率、恢复时间和脑电波活动的影响

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-06-01 DOI: 10.1016/j.redare.2025.501730

B.M. Çam , H. Topçu , E.S. Tiryaki , G. Arslan

Objective

To determine whether caffeine affects the respiratory rate, recovery time, and brain slow-wave (theta and delta) activity during emergence from sevoflurane anaesthesia in rats.

Methods

Male Sprague-Dawley rats (n = 16) were randomly divided into two groups: control (saline) and caffeine (75 mg/kg). After tripolar electrode implantation, rats were placed in an anaesthesia induction chamber and brain electrocorticographic wave activity was recorded. Anaesthesia was induced with 4% sevoflurane (4 L/min O2) for 5 min, and once all the rats were asleep, sevoflurane concentration was reduced to 3% (4 L/min O2) for anaesthesia maintenance. Saline or caffeine was injected intraperitoneally 10 min before discontinuing anaesthesia. After sevoflurane was stopped, the rats were removed from the chamber, and the respiratory rate, tail clamp response, and the righting reflex (full emergence) were observed and noted. The frequency and amplitude of theta and delta waves (from baseline) and the frequency of theta oscillations were calculated from ECoG recordings.

Results

Caffeine administration increased the respiratory rate during sevoflurane anaesthesia; however, no significant difference vs controls was observed during full emergence. The time to tail clamp response and righting reflex, theta oscillations, and the frequency and amplitude of slow waves decreased with caffeine.

Conclusions

Acute administration of caffeine accelerates the emergence from sevoflurane anaesthesia by affecting the central nervous system. There is evidence that prolonged emergence from anaesthesia increases postoperative delirium, therefore intraoperative caffeine may reduce this risk.

目的：研究咖啡因对七氟醚麻醉苏醒大鼠呼吸频率、恢复时间和脑慢波（θ波和δ波）活动的影响。方法：雄性Wistar大鼠16只，随机分为对照组（生理盐水）和咖啡因组（75 mg/kg）。三极电极植入后，将大鼠置于麻醉诱导室，记录脑皮质电波活动。用4%七氟醚（4 l/min O2）麻醉5分钟，待大鼠全部入睡后，将七氟醚浓度降至3% （4 l/min O2）维持麻醉。在停止麻醉前10分钟腹腔注射生理盐水或咖啡因。停用七氟醚后，将大鼠移出室，观察并记录呼吸频率、尾夹反应、翻正反射（完全出现）。θ波和δ波的频率和振幅（基线）以及θ波振荡的频率根据ECoG记录计算。结果：在七氟醚麻醉过程中，咖啡因能提高呼吸频率；然而，与对照组相比，在完全出现期间没有观察到显著差异。咖啡因降低了小鼠尾夹反应时间、翻正反射时间、θ波振荡时间以及慢波频率和振幅。结论：急性给药咖啡因通过影响中枢神经系统加速七氟醚麻醉苏醒。有证据表明长时间的麻醉苏醒会增加术后谵妄，因此术中咖啡因可以降低这种风险。

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引用次数: 0

Intercostal serratus plane block versus posterior quadratuus lumbar block in laparoscopic nephrectomy: A randomized, controlled, double-blind study 肋间锯肌平面阻滞与后腰方肌阻滞在腹腔镜肾切除术中的应用：一项随机、对照、双盲研究。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-06-01 DOI: 10.1016/j.redare.2025.501728

M.T. Fernandez Martin , M.G. Matesanz , J. Andres , H. Muñoz , M.F. Muñoz , A. Fadrique , P. Castillo , P. Casas , S. Lopez

Background

Even though laparoscopic nephrectomy improves the quality of postoperative recovery, it still causes moderate to severe pain. Our objective was to determine whether serratus intercostal plane block (SIPB) was noninferior to posterior quadratus lumborum block (QLB) in terms of pain control and quality of recovery.

Methods

This multicentre, controlled, randomized, blinded study had a sample size of 120 patients who were randomly assigned to SIPB, QLB, and control groups prior to scheduled laparoscopic nephrectomy. We collected the following variables: postoperative dynamic pain scores at 0, 6, 12, and 24 h, postoperative quality of recovery (QoR15), and total opioid consumption (fentanyl and morphine).

Results

Our results show that SIPB was non-inferior to QLB with regard to the primary endpoint (NRS 0.4/0.9) and quality of recovery (QoR15 112.7/106.85) (p 0.27). Opioid consumption (fentanyl p 0.37 and morphine p 0.9) was similar in the SIPB and QLB groups, and both groups were superior to controls in terms of intraoperative fentanyl consumption (p 0.001) and pain control (p < 0.001).

Conclusions

SIPB and QLB showed adequate postoperative pain control, good quality of recovery and lower fentanyl consumption, especially compared to the control group.

背景：尽管腹腔镜肾切除术提高了术后恢复质量，但仍会引起中度至重度疼痛。我们的目的是确定在疼痛控制和恢复质量方面，锯肌肋间平面阻滞（SIPB）是否优于腰后方肌阻滞（QLB）。方法：这项多中心、对照、随机、盲法研究的样本量为120例患者，他们在预定的腹腔镜肾切除术前被随机分配到SIPB组、QLB组和对照组。我们收集了以下变量：术后0、6、12和24小时的动态疼痛评分，术后恢复质量（QoR15）和阿片类药物总用量（芬太尼和吗啡）。结果：我们的研究结果显示，在主要终点（NRS 0.4/0.9）和恢复质量（QoR15 112.7/106.85）方面，SIPB不逊于QLB （p 0.27）。SIPB组和QLB组的阿片类药物用量（芬太尼p 0.37，吗啡p 0.9）相似，两组在术中芬太尼用量（p 0.001）和疼痛控制(p)方面均优于对照组。结论：SIPB组和QLB组术后疼痛控制良好，恢复质量好，芬太尼用量较低，特别是与对照组相比。

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引用次数: 0

Postoperative anaemia is associated with poor long term postoperative outcomes after elective colorectal oncologic surgery within an enhanced recovery after surgery pathway 术后贫血与择期结直肠肿瘤手术后较差的术后长期预后相关，术后恢复途径增强。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-05-01 DOI: 10.1016/j.redare.2025.501724

J. Ripollés-Melchor , A. Abad-Motos , M.L. Fuenmayor-Valera , A. Ruiz-Escobar , A. Abad-Gurumeta , G. Paseiro-Crespo , P. Fernández-Valdés-Bango , A. León-Bretscher , P. Soto-García , C. Jericó-Alba , J.A. García-Erce

Background

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.

Objective

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.

Methods

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.

Results

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 < 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.

Conclusions

The combined prognostic value of preoperative anaemia, postoperative anaemia, and blood transfusion created a 40.7% higher risk of not surviving 5 years.

背景：贫血是腹部大手术后围手术期不良预后的独立风险因素，与非心脏手术后30天死亡率风险增加有关：目的：在一家拥有完善的术后恢复强化计划（ERAS）的中心，调查结直肠肿瘤手术后贫血的发生率以及短期和长期生存率：我们对2013年至2017年期间在本院接受ERAS路径下择期结直肠肿瘤手术的所有患者进行了一项回顾性队列研究。采用 Kaplan-Meier 对数等级法和基于出院时贫血的 Cox 比例危险回归法计算总生存率：共纳入680名患者。出院时贫血的患者5年总生存率较低（53.9%对44%，P 0.05）。出院时贫血患者的 5 年总生存率较低（危险比 [HR] 95% CI 2.663 [1.619-4.379]，P 结论：手术后贫血患者的预后综合价值高于出院时贫血患者：术前贫血、术后贫血和输血的综合预后价值使患者无法存活 5 年的风险增加了 40.7%。

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引用次数: 0

Underbody carbon-fiber contact warming versus underbody forced-air warming to prevent hypothermia during laparoscopic gynecologic surgery: A randomized trial 在腹腔镜妇科手术中，皮下碳纤维接触加热与皮下强制空气加热预防体温过低：一项随机试验

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-05-01 DOI: 10.1016/j.redare.2025.501689

M. Chanzá , M. Núñez , M.C. Velasco , C. Rodríguez-Cosmen , A.C. Carpintero , L. Gallart

Background

Studies comparing intraoperative warming devices report discordant or out-of-date results. This trial compared two underbody warming devices.

Methods

Thirty patients undergoing elective prolonged laparoscopic gynecologic surgery were randomized to underbody warming by forced air (n = 15) or contact with a carbon fibre blanket (n = 15). The main outcome was esophageal temperature at the end of surgery. We also compared temperature throughout surgery and need for rescue warming, blood loss, fluids infused, urine output, and adverse events. Outcomes were compared with χ² or Fisher exact tests, t-tests, and mixed effects models as appropriate.

Results

No median (interquartile range) differences between forced-air and contact warming were found in initial or final temperatures (36.2 °C [36.0, 36.2] vs 36.3 °C [35.9, 36.6] and 36.6 °C [36.2, 36.8] vs 36.3 °C [35.6, 36.5]). Temperature slightly increased over time in the forced-air group and slightly decreased in contact group (0.11 °C/h (0.02, 0.19) vs −0.05 °C/h (−0.13, 0.03), p = 0.008). A single patient required rescue warming (in contact group after 4.75 h). Surgery took longer in the contact group (3.2 h [2.5, 3.8] vs 4.0 h [2.9, 5.6] h, p = 0.042). Two surgeons complained of dizziness related to ambient heat in the forced-air group. No differences were found in the remaining variables.

Conclusions

During use of the underbody forced-air and carbon-fibre warming devices tested, we recorded only very slight differences in temperature changes over the course of surgery. The variations can be considered clinically unimportant as no significant difference was evident at the end of surgery.

背景：比较术中加热装置的研究报告了不一致或过时的结果。该试验比较了两种人体下暖装置。方法：30例选择性长时间腹腔镜妇科手术患者随机分为强制空气加热组（n = 15）和接触碳纤维毯组（n = 15）。主要观察指标为手术结束时食管温度。我们还比较了整个手术过程中的温度和急救温度、失血量、输液量、尿量和不良事件。采用χ 2或Fisher精确检验、t检验和混合效应模型对结果进行比较。结果：在初始或最终温度（36.2°C [36.0, 36.2] vs 36.3°C[35.9, 36.6]和36.6°C [36.2, 36.8] vs 36.3°C[35.6, 36.5]）中，强制空气加热和接触加热之间没有中位数（四分位数范围）差异。加压空气组的温度随时间略有升高，接触组的温度略有下降(0.11°C/h （0.02, 0.19) vs -0.05°C/h (-0.13, 0.03), p = 0.008）。1例患者需要急救加热（接触组为4.75 h），接触组手术时间更长（3.2 h [2.5, 3.8] vs 4.0 h [2.9, 5.6] h, p = 0.042）。在强制空气组中，两名外科医生抱怨与环境高温有关的头晕。其余变量没有发现差异。结论：在使用体底加压空气和碳纤维加热装置的过程中，我们在手术过程中记录到的温度变化只有非常微小的差异。这些差异在临床上不重要，因为在手术结束时没有明显的差异。

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引用次数: 0

External cephalic version and neuroaxial analgesia. A secondary analysis 头外型和神经轴性镇痛。二次分析。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-05-01 DOI: 10.1016/j.redare.2025.501663

H.J. Lacassie , L. Basso , L. Marfán , M. Astete

引用次数: 0

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