Revista espanola de anestesiologia y reanimacion最新文献

英文中文

Comparative evaluation of the effect of application of external manoeuvres with no manoeuvre on glottis view during videolaryngoscopy in patients undergoing elective surgery with the head in neutral position 头部择期手术中立位患者视颈喉镜检查时，外操与无操对声门视像影响的比较评价。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-03-01 Epub Date: 2026-01-20 DOI: 10.1016/j.redare.2026.502016

S. Panda , N. Agrawal , K. Jain V , A. Gupta

Objectives

In patients with cervical spine injury, glottic visualization is difficult in the head-neutral position. The role of external laryngeal manoeuvres, such as backward-upward-rightward pressure (BURP) and jaw thrust in intubation outcomes remains unclear. We compared the effects of jaw thrust and BURP on the quality of glottic view with the head in a neutral position during C-MAC videolaryngoscopy.

Methods

In this self-controlled study, glottic view was assessed in 120 adult patients using a C-MAC videolaryngoscope with no manoeuvre, BURP, or jaw thrust. After induction, endotracheal intubation was performed according to Grupo allocation. Screenshots of the best glottic view were taken each time to assess the percentage of glottic opening (POGO) score, modified Cormack-Lehane (MCL) grade, and glottic opening area en píxeles cuadrados. Intubation times, ease of intubation, haemodynamics, and complications were also recorded.

Results

POGO scores (mean[DE]) were significantly higher with BURP (72.7[19.9]) and jaw thrust (60[26.3]) manoeuvres compared to no manoeuvre (25[26.9];P < 0.0001). Glottic opening area en píxeles cuadrados (P < 0.001) and MCL grades (P = 0.043) were considerably higher after the application of laryngeal manoeuvres. There were no significant differences in the duration of laryngoscopy and intubation times between Grupos; however, intubation was significantly easier with BURP (P = 0.021) and jaw thrust (P = 0.032).

Conclusion

External manoeuvres, such as BURP and jaw thrust, should improve glottic view during C-MAC videolaryngoscopy in patients with the head in a neutral position.

目的：在颈椎损伤患者中，头中位声门显像困难。喉外操作，如向后、向上、向右施压（BURP）和下颌推力在插管结果中的作用尚不清楚。我们比较了在C-MAC视频喉镜检查中，头部处于中立位时，下颌推力和BURP对声门图像质量的影响。方法：在这项自我控制的研究中，使用C-MAC视频喉镜评估120名成年患者的声门视图，无操作，BURP或颚推力。诱导后按分组进行气管插管。每次拍摄最佳声门视图的截图，以评估声门打开百分比（POGO）评分，修改Cormack-Lehane （MCL）评分和声门打开面积（píxeles cuadrados）。同时记录插管时间、插管难易程度、血流动力学及并发症。结果：与无运动（25[26.9]）相比，BURP（72.7[19.9]）和颌突（60[26.3]）的POGO评分（mean[DE]）显著高于BURP（72.7[19.9]）和颌突（60[26.3]）的POGO评分（mean[DE]）；P结论：BURP和颌突等外部运动可改善头部处于中立位的C-MAC视频喉镜检查患者的声门视野。

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引用次数: 0

Beyond the algorithm: Defending scientific integrity in the age of artificial intelligence 超越算法：捍卫人工智能时代的科学完整性。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-03-01 Epub Date: 2026-01-30 DOI: 10.1016/j.redare.2026.502002

R. Casans-Francés , A. Abad-Gurumeta

引用次数: 0

Clinical prediction in treatment with 8% capsaicin patch for post-traumatic neuropathic pain: A critical perspective based on accumulated evidence 8%辣椒素贴片治疗创伤后神经性疼痛的临床预测：基于积累证据的关键观点。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-03-01 Epub Date: 2026-01-30 DOI: 10.1016/j.redare.2026.501992

A. Alcántara Montero , P.J. Ibor Vidal

引用次数: 0

Factors associated with mortality, length of stay, and limitation of therapeutic effort in patients aged 80 years and older in a surgical ICU: A retrospective observational study 80岁及以上外科ICU患者死亡率、住院时间和治疗效果限制的相关因素：一项回顾性观察性研究

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-03-01 Epub Date: 2026-02-07 DOI: 10.1016/j.redare.2026.502027

F. Guitart de la Lastra, F. Ramasco Rueda, C. Martin, A. Figuerola, A. Calderón, A. García-Jorge

Objectives

To describe the clinical characteristics of patients over 80 years admitted to the Surgical Intensive Care Unit (SICU) of Hospital de La Princesa, and to identify admission variables associated with mortality and prolonged hospital stay. As a secondary objective, we explored decisions regarding limitation of therapeutic effort (LTE), their predictors, and their impact on survival and length of stay.

Material and methods

Retrospective observational study including 100 patients over 80 years admitted to the SICU. Clinical, demographic, and prognostic variables were collected, including age, sex, type of surgery, SOFA and Charlson scores, nutritional status (CONUT), and frailty. Multivariate analysis was performed to identify factors associated with mortality, length of stay, and LTE.

Results

Mean age was 85.8 years (SD ± 4.2). Thirty-day mortality was 16%, and mean ICU length of stay was 5.36 days (SD ± 8.2). Mechanical ventilation was the only factor independently associated with mortality (OR 16.6; 95% CI: 1.5–180.6). Development of sepsis and use of vasoactive drugs were associated with longer hospital stays (p < 0.05). LTE decisions were made in 68% of deceased patients, with no significant differences in survival or length of stay between patients with and without LTE.

Conclusions

Mechanical ventilation is the main predictor of mortality in patients over 80 years admitted to SICU. Sepsis and vasoactive support prolonged hospital stay. LTE decisions are frequent in this population, although no clear predictors for their application were identified.

目的：描述公主医院外科重症监护室（SICU）收治的80岁以上患者的临床特征，并确定与死亡率和住院时间延长相关的入院变量。作为次要目标，我们探讨了有关治疗努力限制（LTE）的决定，其预测因素及其对生存和住院时间的影响。材料和方法：回顾性观察研究，包括100例80岁以上入住SICU的患者。收集临床、人口统计学和预后变量，包括年龄、性别、手术类型、SOFA和Charlson评分、营养状况（CONUT）和虚弱程度。进行多变量分析以确定与死亡率、住院时间和LTE相关的因素。结果：平均年龄85.8岁（SD±4.2）。30天死亡率为16%，平均ICU住院时间为5.36天（SD±8.2）。机械通气是唯一与死亡率独立相关的因素（OR: 16.6; 95% CI: 1.5-180.6）。脓毒症的发展和血管活性药物的使用与更长的住院时间相关(p结论：机械通气是80岁以上SICU患者死亡率的主要预测因素。脓毒症和血管活性支持延长住院时间。LTE决策在这一人群中很常见，尽管没有明确的预测其应用的因素。

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引用次数: 0

Clinical practice guidelines on parental accompaniment in the operating theatre during anaesthetic induction in paediatrics 儿科麻醉诱导手术中父母陪同的临床实践指南。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-03-01 Epub Date: 2026-02-07 DOI: 10.1016/j.redare.2026.502028

M. López Segura , P. Sanabria Carretero , D. Gil Mayo , D. Fabián González , C. Solé Bertran , A.J. Winter , F.J. Escribá Alepuz , J. García Fernández

Introduction

Parental accompaniment during anesthesia induction in pediatric patients has become a key strategy in the humanization of surgical care. Various studies have demonstrated its benefits in reducing anxiety in both the pediatric patient and their parents, promoting cooperation and enhancing the perioperative experience. Consequently, there is a need for a clinical practice guideline to guide anesthesiology professionals in the safe and consistent application of this intervention.

Objective

To develop a clinical practice guideline that establishes evidence-based recommendations, based on expert consensus, for implementing parental accompaniment during anesthesia induction in the pediatric operating room.

Methods

The Humanization Working Group of the Pediatric Section of the Spanish Society of Anesthesia and Resuscitation (SEDAR) conducted a systematic review of national and international scientific literature, complemented by a multidisciplinary consensus process using the GRADE methodology and the Delphi technique.

Results

The guideline defines inclusion and exclusion criteria for patients and companions, proposes a structured action protocol, details safety measures, staff training, and communication strategies with families. Additionally, it offers specific recommendations for different hospital contexts and clinical situations.

Conclusions

This guideline serves as a practical tool to facilitate the implementation of parental accompaniment in pediatric operating rooms, in line with policies of humanization and quality of care. Its adoption will help improve the pediatric perioperative experience and strengthen the trust relationship between healthcare professionals and families.

儿童麻醉诱导过程中父母的陪伴已成为手术护理人性化的关键策略。各种研究已经证明它在减少儿科患者及其父母的焦虑，促进合作和增强围手术期体验方面的益处。因此，有必要制定临床实践指南，指导麻醉专业人员安全、一致地应用这种干预措施。目的：制定一份临床实践指南，在专家共识的基础上，为儿科手术室麻醉诱导过程中父母陪同的实施提供循证建议。方法：西班牙麻醉与复苏学会（SEDAR）儿科人性化工作组对国内和国际科学文献进行了系统回顾，并辅以采用GRADE方法和德尔菲技术的多学科共识过程。结果：该指南定义了患者及其陪伴者的纳入和排除标准，提出了结构化的行动方案，详细说明了安全措施、工作人员培训以及与家属的沟通策略。此外，它还针对不同的医院环境和临床情况提供具体建议。结论：本指南是促进父母陪伴在儿科手术室实施的实用工具，符合人性化和护理质量的方针。它的采用将有助于改善儿科围手术期的体验，并加强医护人员和家庭之间的信任关系。

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引用次数: 0

Radiological pattern of intradural injection of radiopaque contrast 胸腔内放射不透明对比注射的放射模式：胸腔内放射不透明对比注射模式。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-03-01 Epub Date: 2026-02-11 DOI: 10.1016/j.redare.2026.502004

F. Galván-Román, Á. Alonso Chico, L. Gómez Suárez, M.V. López-Chuecos

引用次数: 0

Diaphragm-sparing shoulder regional anesthesia techniques: Understanding the concepts and clinical applications. 肩部保留膈肌区域麻醉技术的概念及临床应用。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-02-26 DOI: 10.1016/j.redare.2026.502038

R M Sethuraman

引用次数: 0

Giant polycystic liver disease with thoracic involvement: An anaesthesia and surgical challenge in liver transplantation. 累及胸部的巨大多囊性肝病：肝移植的麻醉和手术挑战。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-02-20 DOI: 10.1016/j.redare.2026.502025

M Arias Salazar, F G Mileo, G Chullo, Y Fundora, E Quintana, J Martínez

Polycystic liver disease is a rare inherited disorder that is usually associated with autosomal dominant polycystic kidney disease. Advanced forms of the disease can cause massive hepatomegaly, chest compression, and severe respiratory compromise. We present the case of a 46-year-old woman with hepatorenal polycystic disease who developed progressive dyspnoea, early satiety, and abdominal distension despite treatment with lanreotide. The CT scan revealed a liver measuring 14,200 cc, partial lung collapse, and mediastinal displacement. Given the risk of thoracic compression, an orthotopic liver transplant was performed using a sterno-laparotomy approach and femoro-portal veno-venous bypass to achieve haemodynamic stability during the anhepatic phase. The evolution was favourable, and the patient was discharged on day 11 and re-assessed at 6 months without incident. This case highlights the importance of multidisciplinary planning and the selective use of veno-venous bypass to ensure safe anaesthesia and surgical management in giant polycystic liver disease.

多囊性肝病是一种罕见的遗传性疾病，通常与常染色体显性多囊性肾病相关。这种疾病的晚期可导致大面积的肝肿大、胸部压迫和严重的呼吸损害。我们报告一位患有肝肾多囊性疾病的46岁女性患者，尽管接受了lanreotide治疗，但仍出现了进行性呼吸困难、早期饱腹感和腹胀。CT扫描显示肝脏面积14200cc，部分肺萎陷，纵隔移位。考虑到胸部压迫的风险，采用胸腹开腹入路和股-门静脉-静脉旁路术进行原位肝移植，以在无肝期实现血流动力学稳定。病情进展良好，患者于第11天出院，6个月时重新评估，无任何意外。本病例强调了多学科规划和选择性使用静脉-静脉旁路手术的重要性，以确保巨大多囊肝疾病的安全麻醉和手术管理。

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引用次数: 0

Reflections on: "Comparison of single-shot neuraxial morphine and erector spinae plane block on quality of recovery after major open gastrointestinal surgeries". 关于“单针注射吗啡与竖脊肌平面阻滞对胃肠大开腹手术后恢复质量的比较”的思考。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-02-20 DOI: 10.1016/j.redare.2026.502045

R M Sethuraman, R Aravindan

引用次数: 0

Air vs. saline for epidural space identification: Why we should move away from air in obstetric analgesia. 空气与生理盐水用于硬膜外间隙识别：为什么我们应该在产科镇痛中远离空气。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-02-20 DOI: 10.1016/j.redare.2026.502040

N Brogly, E Guasch, I Valbuena Gómez, F Gilsanz

引用次数: 0

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Revista espanola de anestesiologia y reanimacion

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