Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501876
B. Segura-Méndez, R. Bernal-Esteban, N. Arce-Ramos, Y. Carrascal
{"title":"Acute coronary syndrome due to compression by giant sinus of Valsalva aneurysm","authors":"B. Segura-Méndez, R. Bernal-Esteban, N. Arce-Ramos, Y. Carrascal","doi":"10.1016/j.redare.2025.501876","DOIUrl":"10.1016/j.redare.2025.501876","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501876"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180794","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}
Pub Date : 2025-12-01DOI: 10.1016/j.redare.2025.501951
S. Diwan , V. Sathe , A. Sabnis , P. Mane , A. Gupta
Background
The terminal nerves of the lumbar plexus, the femoral and obturator nerves, and the sciatic nerve are situated in different fascial planes on the medial side of the thigh. Attempts have been made to approach these nerves using a single puncture from the anterior and medial aspect of the thigh. The previously described SOFT block requires multiple transducer positions, needle redirections, and punctures. We attempted a novel single-puncture, single-position approach to all 3 nerves in different fascial planes in 6 soft embalmed cadavers that provided a total of 12 specimens.
Methods
Six fresh human cadavers left at room temperature for a minimum of 6 h were positioned supine, and an ultrasound-guided single puncture technique was used to target branches of the sciatic, femoral, and obturator nerves (SP-SFO) and inject 0.1% methylene blue dye. Cross-sections were obtained with a band saw in all cadavers at the level of the SP-SFO injections to observe the spread of the dye in various planes.
Results
Cadaver cross-sections showed the spread of the dye in all respective planes. The dye infiltrated the femoral and obturator nerves, while in 4 specimens it reached the sciatic nerve and the paraneural tissue.
Conclusion
This single puncture for branches of the sciatic, femoral, and obturator nerves block (SP-FSO block) can be used to successfully target all these nerves.
{"title":"Single-puncture ultrasound-guided sciatic, femoral, and obturator injection (SP-SFO): Spread of dye in cadavers","authors":"S. Diwan , V. Sathe , A. Sabnis , P. Mane , A. Gupta","doi":"10.1016/j.redare.2025.501951","DOIUrl":"10.1016/j.redare.2025.501951","url":null,"abstract":"<div><h3>Background</h3><div>The terminal nerves of the lumbar plexus, the femoral and obturator nerves, and the sciatic nerve are situated in different fascial planes on the medial side of the thigh. Attempts have been made to approach these nerves using a single puncture from the anterior and medial aspect of the thigh. The previously described SOFT block requires multiple transducer positions, needle redirections, and punctures. We attempted a novel single-puncture, single-position approach to all 3 nerves in different fascial planes in 6 soft embalmed cadavers that provided a total of 12 specimens.</div></div><div><h3>Methods</h3><div>Six fresh human cadavers left at room temperature for a minimum of 6 h were positioned supine, and an ultrasound-guided single puncture technique was used to target branches of the sciatic, femoral, and obturator nerves (SP-SFO) and inject 0.1% methylene blue dye. Cross-sections were obtained with a band saw in all cadavers at the level of the SP-SFO injections to observe the spread of the dye in various planes.</div></div><div><h3>Results</h3><div>Cadaver cross-sections showed the spread of the dye in all respective planes. The dye infiltrated the femoral and obturator nerves, while in 4 specimens it reached the sciatic nerve and the paraneural tissue.</div></div><div><h3>Conclusion</h3><div>This single puncture for branches of the sciatic, femoral, and obturator nerves block (SP-FSO block) can be used to successfully target all these nerves.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 10","pages":"Article 501951"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228719","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}
Pub Date : 2025-11-01DOI: 10.1016/j.redare.2025.501802
C. Juliá-Romero , B. Simón-Rivero , L. Ceresuela-Dionís , S. de Benito-Mendieta
{"title":"Impact of facial fillers on airway assessment","authors":"C. Juliá-Romero , B. Simón-Rivero , L. Ceresuela-Dionís , S. de Benito-Mendieta","doi":"10.1016/j.redare.2025.501802","DOIUrl":"10.1016/j.redare.2025.501802","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 9","pages":"Article 501802"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295557","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}
Pub Date : 2025-11-01DOI: 10.1016/j.redare.2025.501928
H.D. de Boer, B.M. Biccard, B. Riedel
{"title":"Perioperative quality improvement programs: A global perioperative network is urgently needed to promote education, collaboration, and contextual innovation","authors":"H.D. de Boer, B.M. Biccard, B. Riedel","doi":"10.1016/j.redare.2025.501928","DOIUrl":"10.1016/j.redare.2025.501928","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 9","pages":"Article 501928"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002297","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}
Pub Date : 2025-11-01DOI: 10.1016/j.redare.2025.501926
J. Ripollés-Melchor , A. Zorrilla-Vaca , A. León-Bretscher , A. Abad-Motos , P. Galán-Menéndez , J.L. Muñoz-Rodés , D. Zapata , Á. Ramiro-Ruiz , C. Aldecoa , V. Molnar , L. Jordá-Sanz , A. Cuéllar-Martínez , H. Berges-Gutiérrez , A. Landaluce-Olavarria , R. Fernández-García , N. Aracil-Escoda , A.M. Pacual-Bellosta , M. Ubré-Lorenzo , M. Logroño-Ejea , A.B. Serrano Romero , A. Abad-Gurumeta
Introduction/objectives
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.
Methods
This sub-analysis included 901 patients from 32 hospitals with available 5-year follow-up data. Patients undergoing elective CRC resection were stratified based on ERAS adherence (≥70%). Primary outcomes included overall survival and recurrence rates analysed using Cox proportional hazards models adjusted for clinical variables. Kaplan–Meier curves and subgroup analyses were also performed to assess stage-specific differences.
Results
No significant differences were observed in 5-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.
Conclusions
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.
{"title":"Enhanced recovery after surgery and long-term oncologic outcomes: Post-hoc analysis of the POWER study","authors":"J. Ripollés-Melchor , A. Zorrilla-Vaca , A. León-Bretscher , A. Abad-Motos , P. Galán-Menéndez , J.L. Muñoz-Rodés , D. Zapata , Á. Ramiro-Ruiz , C. Aldecoa , V. Molnar , L. Jordá-Sanz , A. Cuéllar-Martínez , H. Berges-Gutiérrez , A. Landaluce-Olavarria , R. Fernández-García , N. Aracil-Escoda , A.M. Pacual-Bellosta , M. Ubré-Lorenzo , M. Logroño-Ejea , A.B. Serrano Romero , A. Abad-Gurumeta","doi":"10.1016/j.redare.2025.501926","DOIUrl":"10.1016/j.redare.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 5-year follow-up data. Patients undergoing elective CRC resection were stratified based on ERAS adherence (≥70%). Primary outcomes included overall survival and recurrence rates analysed 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 5-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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 9","pages":"Article 501926"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006965","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}
Pub Date : 2025-11-01DOI: 10.1016/j.redare.2025.501904
Y. Li , Z. Jin , L. Beiping , A. Xiaolei
Objective
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.
Methods
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.
Results
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, p < 0.001; TOM: F = 12.196, p < 0.001), while the OLM recognition index showed no significant change (one-way ANOVA: F = 0.057, p = 0.982). Furthermore, c-Fos positive neurons in the dorsal hippocampus of aged mice decreased significantly one day after surgery (one-way ANOVA: F = 0.057, p = 0.0048). 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 = 0.032, p = 0.021; TOM: F = 0.024, p = 0.019) and depletion of dendritic spine density (p < 0.01).
Conclusion
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.
目的：本研究旨在探讨麻醉和手术对幼龄和老年小鼠认知功能的影响。探讨c-Fos表达在改变小鼠海马神经元兴奋性中的作用和机制及其与围手术期神经认知障碍的关系。方法：在本研究中，我们使用小鼠剖腹手术模型来评估术后1、3和7天幼龄和老年小鼠的认知行为变化。我们采用免疫荧光技术检测老年小鼠剖腹手术后海马背侧c-Fos的表达。我们还使用了化学遗传方法，向海马背侧注射病毒来调节神经元的兴奋性，随后分析了物体位置记忆（OLM）和时间顺序记忆（TOM）的变化。此外，我们用高尔基染色法观察麻醉和注射病毒后老年小鼠海马背区树突棘的密度。结果：与各自的对照组相比，单独麻醉的年轻小鼠和老年小鼠之间没有明显的认知差异。然而，只有接受手术的老年小鼠在术后1天的OLM和T-maze任务中表现出明显的缺陷（单因素方差分析：OLM: F = 27.507， P）。结论：手术后老年小鼠的时空记忆功能受损，而物体识别记忆未受影响。手术导致老年小鼠海马背侧c-Fos阳性神经元数量减少，神经元兴奋性降低。此外，增强海马背侧神经元兴奋性可减轻老年小鼠术后认知功能障碍。此外，海马背侧神经元兴奋性的增加可以抵消手术引起的树突棘密度的减少。
{"title":"Effects of anaesthesia on cognitive function in young and aged mice: Role of c-Fos expression in hippocampal neuron excitability","authors":"Y. Li , Z. Jin , L. Beiping , A. Xiaolei","doi":"10.1016/j.redare.2025.501904","DOIUrl":"10.1016/j.redare.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, p < 0.001; TOM: F = 12.196, p < 0.001), while the OLM recognition index showed no significant change (one-way ANOVA: F = 0.057, p = 0.982). Furthermore, c-Fos positive neurons in the dorsal hippocampus of aged mice decreased significantly one day after surgery (one-way ANOVA: F = 0.057, p = 0.0048). 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 = 0.032, p = 0.021; TOM: F = 0.024, p = 0.019) and depletion of dendritic spine density (p < 0.01).</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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 9","pages":"Article 501904"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008620","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}
Pub Date : 2025-11-01DOI: 10.1016/j.redare.2025.501903
L. Arce Gálvez , J.M. Mancera Álzate
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.
{"title":"Perineural botulinum toxin in the management of post-traumatic headache: A case report","authors":"L. Arce Gálvez , J.M. Mancera Álzate","doi":"10.1016/j.redare.2025.501903","DOIUrl":"10.1016/j.redare.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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 9","pages":"Article 501903"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016917","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}
Pub Date : 2025-11-01DOI: 10.1016/j.redare.2025.501925
A. Choudhary , S. Singh , V. Kumar , H. Kumar , K. Parasar
Background
It is crucial to assess a patient's quality of recovery after major surgery. This study aims to compare the effect of neuraxial morphine and bilateral erector spinae plane block on quality of recovery in the first 48 postoperative hours in patients undergoing open upper abdominal surgeries.
Methods
This prospective, triple-arm, randomized study was performed to compare the effect of neuraxial morphine (intrathecal morphine, thoracic epidural) and 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 rated on the numerical rating scale (NRS) score over 24 h after surgery, time to first rescue analgesia, and adverse effects.
Results
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 the bilateral low volume erector spinae plane block (LV-ESPB) group. The 24-h QoR-15 scores (mean ± standard deviation) were comparable in the ITM (115.83 ± 4.0) and TEM (113.51 ± 4.36) groups, but were significantly lower in the LV-ESPB group (104.58 ± 4.05) (p < 0.001). NRS scores were comparable at all time points in all 3 groups, except at 24 h (p - 0.002). The time to first rescue analgesia was comparable in all 3 groups. The incidence of nausea and pruritus was statistically significant in the ITM group vs the TEM and LV-ESPB groups (p < 0.001 and 0.019, respectively).
Conclusions
The study demonstrated that neuraxial morphine achieved better quality of recovery in the first 24 h after major abdominal surgery vs bilateral erector spinae plane block.
{"title":"Comparison of single-shot neuraxial morphine and erector spinae plane block on quality of recovery after major open gastrointestinal surgeries: A prospective, randomized trial","authors":"A. Choudhary , S. Singh , V. Kumar , H. Kumar , K. Parasar","doi":"10.1016/j.redare.2025.501925","DOIUrl":"10.1016/j.redare.2025.501925","url":null,"abstract":"<div><h3>Background</h3><div>It is crucial to assess a patient's quality of recovery after major surgery. This study aims to compare the effect of neuraxial morphine and bilateral erector spinae plane block on quality of recovery in the first 48 postoperative hours in patients undergoing open upper abdominal surgeries.</div></div><div><h3>Methods</h3><div>This prospective, triple-arm, randomized study was performed to compare the effect of neuraxial morphine (intrathecal morphine, thoracic epidural) and 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 rated on the numerical rating scale (NRS) score over 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 the bilateral low volume erector spinae plane block (LV-ESPB) group. The 24-h QoR-15 scores (mean ± standard deviation) were comparable in the ITM (115.83 ± 4.0) and TEM (113.51 ± 4.36) groups, but were significantly lower in the LV-ESPB group (104.58 ± 4.05) (<em>p</em> < 0.001). NRS scores were comparable at all time points in all 3 groups, except at 24 h (<em>p</em> - 0.002). The time to first rescue analgesia was comparable in all 3 groups. The incidence of nausea and pruritus was statistically significant in the ITM group vs the TEM and LV-ESPB groups (<em>p</em> < 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 h after major abdominal surgery vs bilateral erector spinae plane block.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 9","pages":"Article 501925"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016945","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}
Pub Date : 2025-11-01DOI: 10.1016/j.redare.2025.501913
C. Barreiros , J. Mejía , I. García-Rojas , X. Sala-Blanch
{"title":"Quality of training in ultrasound-guided regional anaesthesia in teaching hospitals in Catalonia: An opinion survey of residents and tutors","authors":"C. Barreiros , J. Mejía , I. García-Rojas , X. Sala-Blanch","doi":"10.1016/j.redare.2025.501913","DOIUrl":"10.1016/j.redare.2025.501913","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 9","pages":"Article 501913"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008656","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}
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