Revista espanola de anestesiologia y reanimacion最新文献

英文中文

Subcutaneous emphysema as an airway emergency following tracheostomy closure 气管切开术后的气道急症皮下肺气肿。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-02-01 Epub Date: 2026-01-23 DOI: 10.1016/j.redare.2026.502018

M. Linares, G. Álvarez Roca, R. Riera-Pérez, M. López-Baamonde

引用次数: 0

Impact of preanesthetic consultation on presurgical anxiety assessed using the Amsterdam Preoperative Anxiety and Information Scale 使用阿姆斯特丹术前焦虑和信息量表评估麻醉前会诊对术前焦虑的影响。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-02-01 Epub Date: 2026-01-30 DOI: 10.1016/j.redare.2026.502005

M.M. Ureña Consuegra, Y.V. Llaverías Guzmán, L.R. Peralta Henson, S.E. Tejada Estrella, V.M. Cepeda Santos

Background

Preanesthesia consultation can be an effective tool for reducing anxiety scores in patients scheduled for elective surgery. Anxiety can cause perioperative complications.

Objective

was to determine the impact of preanesthesia consultation on anxiety scores.

Patients and methods

A single-center, observational study was carried out, with a descriptive, cross-sectional design and primary source. The anxiety score assessed using the APAIS scale (Amsterdam Preoperative Anxiety and Information Scale) was evaluated in adult participants before and after the pre-anesthetic consultation during the period December 2024 to April 2025. Statistical analysis was performed using the Wilcoxon, McNemar and chi-square tests. A P value < 0.05 was considered significant.

Results

A total of 190 participants were interviewed, of whom 180 were ultimately analyzed; 76.7% were women, and the mean age was 41.6 years. The most frequent procedures were general surgery and gynecological procedures. 86.7% had previously received anaesthesia. The prevalence of pre-consultation anxiety was 68.3%, decreasing to 47.2% after the consultation (p = 0.001). All interviewees between the ages of 18 and 25 reported anxiety before the pre-anaesthesia consultation (p = 0.031). The anesthetic technique that generated the greatest fear was general anaesthesia (42.8%), with the most frequently reported cause being fear of death (15.6%).

Conclusion

Preoperative anxiety is highly prevalent, and preanesthetic consultation could be an effective intervention to significantly reduce it.

背景：麻醉前咨询是降低择期手术患者焦虑评分的有效工具。焦虑可引起围手术期并发症。目的：探讨麻醉前咨询对患者焦虑评分的影响。患者和方法：采用描述性、横断面设计和主要来源的单中心观察性研究。在2024年12月至2025年4月期间，使用APAIS量表（阿姆斯特丹术前焦虑和信息量表）评估成人参与者在麻醉前会诊前后的焦虑评分。采用Wilcoxon、McNemar和卡方检验进行统计分析。A P值< 0.05被认为是显著的。结果：共采访了190名参与者，其中180人最终进行了分析；76.7%为女性，平均年龄41.6岁。最常见的手术是普通外科手术和妇科手术。86.7%曾接受过麻醉。会诊前焦虑患病率为68.3%，会诊后降至47.2% （p = 0.001）。所有年龄在18 - 25岁之间的受访者在麻醉前咨询前都报告了焦虑（p = 0.031）。引起最大恐惧的麻醉技术是全身麻醉（42.8%），最常见的报告原因是害怕死亡（15.6%）。结论：术前焦虑普遍存在，麻醉前会诊是有效的干预措施。

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引用次数: 0

Erector spinae plane block in neonates: Case study 新生儿直立棘面阻滞：个案研究。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-02-01 Epub Date: 2026-01-30 DOI: 10.1016/j.redare.2026.502019

J.A. Orozco Arango , P.A. Cruces Muñoz

Pain in neonates, if not adequately treated, can lead to long-term neurological and behavioural consequences. Among the most frequent causes are intrapartum fractures. Although rare, rib fractures represent a diagnostic and therapeutic challenge. This article presents the case of a 36-week neonate with a left rib fracture who exhibited symptoms such as inconsolable crying, feeding refusal, and oxygen desaturation. An ultrasound-guided erector spinae plane block (ESPB) was performed, resulting in significant clinical improvement without complications. Although ESPB has been widely used in adults and older children for the management of thoracic pain, its application in neonates is scarcely documented. This technique offers advantages over other regional analgesic methods, as it is associated with fewer adverse effects and provides direct analgesia to the thoracic nerves. Its use is suggested as a safe and effective alternative, particularly in non-surgical settings.

新生儿疼痛，如果治疗不当，可导致长期的神经和行为后果。其中最常见的原因是产时骨折。虽然罕见，但肋骨骨折对诊断和治疗都是一个挑战。本文报告一例36周大的新生儿左肋骨骨折，表现出哭闹、拒绝进食和氧饱和度过低等症状。超声引导直立脊柱平面阻滞（ESPB），临床效果明显改善，无并发症。虽然ESPB已广泛应用于成人和大龄儿童胸痛的治疗，但其在新生儿中的应用鲜有文献记载。与其他局部镇痛方法相比，该技术具有优势，因为它的不良反应较少，并可直接对胸神经进行镇痛。建议将其作为安全有效的替代方法使用，特别是在非手术环境中。

引用次数: 0

Response to the letter to the editor regarding: ‘New-onset neuropathic and chronic pain in survivors of severe COVID-19: secondary analysis of the PAIN-COVID trial’ 回复给编辑关于“严重COVID-19幸存者的新发神经性和慢性疼痛：pain - covid试验的二次分析”的信。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-01-01 Epub Date: 2025-12-13 DOI: 10.1016/j.redare.2025.501997

A. Ojeda, T. Cuñat, Ó. Comino-Trinidad, J. Aliaga, M. Arias, A. Calvo

引用次数: 0

From uterine atony to aHUS: A case of postpartum thrombotic microangiopathy 产后血栓性微血管病1例。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-01-01 Epub Date: 2026-01-12 DOI: 10.1016/j.redare.2026.501983

J.M. Blanco Flores, A.M. Oubiña López, A. San Antonio Gil, M. Reina Molina, P. Ramos Curado, M. Echevarría Moreno

We report the case of a 42-year-old primiparous woman who developed severe postpartum hemorrhage due to uterine atony after an instrumental delivery, requiring massive transfusion and Bakri balloon placement. Despite initial haemodynamic stabilization, she progressed to persistent anuria and acute kidney injury. Imaging revealed bilateral renal cortical necrosis. Atypical haemolytic uremic syndrome (aHUS) was suspected on the basis of tests showing anaemia, thrombocytopaenia, complement consumption, and ADAMTS13 activity >10%. Treatment with eculizumab and renal replacement therapy was initiated, achieving good haematologic response.

This case highlights a rare postpartum complication in which early suspicion enables prompt targeted therapy. Ansesthesiologists play a key role in initial haemodynamic management and in identifying warning signs suggestive of thrombotic microangiopathies.

我们报告的情况下，42岁的产妇谁发展严重的产后出血，由于子宫张力的工具分娩后，需要大量输血和巴克利球囊安置。尽管最初血流动力学稳定，但她进展为持续无尿和急性肾损伤。影像学显示双侧肾皮质坏死。根据显示贫血、血小板减少、补体消耗和ADAMTS13活性bbb10 %的试验，怀疑为非典型溶血性尿毒症综合征（aHUS）。开始使用eculizumab和肾脏替代疗法治疗，获得良好的血液学反应。这个病例强调了一种罕见的产后并发症，早期的怀疑使及时的靶向治疗成为可能。麻醉师在初始血流动力学管理和识别提示血栓性微血管病变的警告信号中发挥关键作用。

引用次数: 0

Predictive value of muscle tone loss and perfusion index in the success of supraclavicular brachial plexus block: A pilot study 肌张力丧失和灌注指数在锁骨上臂丛阻滞成功中的预测价值：一项初步研究。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-01-01 Epub Date: 2026-01-12 DOI: 10.1016/j.redare.2026.501986

M.A. Hernández-Govea , G.F. Álvarez-Orenday , M. Guerra-Hernández , V.B. Kway , A.M. Castro-Alemán

Background

Currently, no standardized tool accurately predicts the success of supraclavicular brachial plexus block (SBPB) in the shortest time possible. This study aimed to evaluate the early predictive value of muscle tone loss and perfusion index in predicting SBPB success. This is the first study to report the use of this device for objective assessment of nerve block success.

Methods

A prospective observational pilot study was conducted at "Dr. Ignacio Morones Prieto" Central Hospital, Mexico, involving 33 patients (ASA 1, 2, 3) requiring surgery on the distal third of the upper limb with ultrasound-guided SBPB. Exclusion criteria included infections at the puncture site, local anaesthetic allergies, coagulopathies, restrictive pulmonary pathologies, oxygen dependency, brachial plexus radiculopathy, and uncontrolled diabetes. The motor block was assessed with a conductive ink flexion sensor (FS), and the sympathetic block was evaluated with perfusion index via pulse oximeter at 3, 5, 10, and 15 min. Block success was defined as a Numerical Rating Scale (NRS) for pain <2 during surgical stimulation. Statistical comparisons were made between successful and unsuccessful blocks, with ROC curve analysis identifying optimal cutoff points for predictive variables.

Results

Of the 33 patients, 24 had a successful block, and 9 did not. At 5 min, a PI > 196.07 showed 100% sensitivity, 87.5% specificity, and AUC 92% (p < 0.001). A 27.38% loss in muscle strength showed 100% sensitivity, 87.5% specificity, and AUC 95% (p < 0.001). Combined, these parameters had a 100% predictive value (p < 0.005).

Conclusion

PI and muscle strength loss are reliable early predictors of SBPB success, offering a valuable tool for optimizing anaesthetic strategies.

背景：目前，没有标准化的工具能准确预测锁骨上臂丛阻滞（SBPB）在最短时间内的成功。本研究旨在评价肌张力丧失和灌注指数对SBPB成功的早期预测价值。这是首次报道使用该装置客观评估神经阻滞成功的研究。方法：在墨西哥“Dr. Ignacio Morones Prieto”中心医院进行了一项前瞻性观察性先导研究，涉及33例需要在超声引导下上肢远端三分之一行SBPB手术的患者（ASA 1、2、3）。排除标准包括穿刺部位感染、局部麻醉过敏、凝血功能障碍、限制性肺病变、氧依赖、臂丛神经根病变和未控制的糖尿病。在3、5、10和15分钟时，用导电墨水挠曲传感器（FS）评估运动阻滞，用脉搏血氧仪灌注指数评估交感阻滞。阻滞成功被定义为疼痛的数值评定量表（NRS）结果：33例患者中，24例阻滞成功，9例阻滞失败。在5分钟时，PI bb0 196.07的灵敏度为100%，特异性为87.5%，AUC为92% (p)结论：PI和肌力损失是SBPB成功的可靠早期预测指标，为优化麻醉策略提供了有价值的工具。

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引用次数: 0

The effect of opioid-free anesthesia on postoperative pain in orthopedic surgery: A systematic review and meta-analysis of randomized controlled trial 无阿片类药物麻醉对骨科术后疼痛的影响：一项随机对照试验的系统回顾和荟萃分析。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-01-01 Epub Date: 2026-01-10 DOI: 10.1016/j.redare.2026.501989

A. Bachtiar Effendi , F. Cahya Ramadhan , G.D. Ica Manohara , R.M. Laksono

Background

Opioid-free anaesthesia (OFA) is increasingly recognized as a perioperative approach that may offer effective pain control with reduced risk of adverse effects. Considering that orthopaedic surgeries often lead to at least moderate postoperative pain, we assessed the effectiveness and safety of OFA in orthopaedic procedures.

Methods

We searched PubMed, ScienceDirect, ProQuest, and EuropePMC for relevant randomised controlled trials (RCT) and supplemented the data with citation tracking. Data were analysed using RevMan version 5.4. The risk of bias and the certainty of evidence were evaluated using the Cochrane Risk of Bias 2.0 tool and the GRADE approach. The study was registered on PROSPERO (CRD420251048348).

Results

Seven RCTs involving 408 patients were included. The intensity of postoperative pain measured in the post-anaesthesia care unit (mean difference [MD]: −0.08), at 24 h (MD: −0.06), and at 48 h (MD: −0.26) was not statistically significant. OFA reduced the risk of postoperative nausea and vomiting (PONV) (RR: 0.37; P = .00001) and prolonged the time to first request for analgesia (MD: 25.60 min; P = .00001). Twenty-four-hour morphine consumption was comparable across groups (MD: −0.28; P = .76). OFA reduced the incidence of intraoperative hypotension (risk ratio [RR]: 0.56; P = .02) but increased the risk of intraoperative bradycardia (RR: 1.86; P = .04).

Conclusions

In orthopaedic surgery, OFA provides comparable pain control to opioid-based anaesthesia. It also reduced the incidence of postoperative nausea and vomiting and intraoperative hypotension, and prolonged the time to the first request for analgesia (statistically, but not clinically). However, the potential risk of bradycardia should be considered when using dexmedetomidine-based anaesthesia.

背景：无阿片类药物麻醉（OFA）越来越被认为是一种围手术期的方法，可以提供有效的疼痛控制和降低不良反应的风险。考虑到骨科手术经常导致至少中度的术后疼痛，我们评估了OFA在骨科手术中的有效性和安全性。方法：检索PubMed、ScienceDirect、ProQuest和EuropePMC，查找相关的随机对照试验（RCT），并对数据进行引文跟踪。数据采用RevMan 5.4进行分析。使用Cochrane risk of bias 2.0工具和GRADE方法评估偏倚风险和证据的确定性。该研究已在PROSPERO注册（CRD420251048348）。结果：纳入7项随机对照试验，共408例患者。麻醉后护理单元测量的术后疼痛强度（平均差值[MD]: -0.08）， 24小时（MD: -0.06）和48小时（MD: -0.26）无统计学意义。OFA降低了术后恶心和呕吐（PONV）的风险（RR: 0.37; P = 0.00001），延长了首次请求镇痛的时间（MD: 25.60分钟；P = 0.00001）。两组间24小时吗啡用量具有可比性（MD: -0.28; P = 0.76）。OFA降低术中低血压的发生率（危险比[RR]: 0.56; P = 0.02），但增加术中心动过缓的风险（危险比[RR]: 1.86; P = 0.04）。结论：在骨科手术中，OFA提供了与阿片类药物麻醉相当的疼痛控制。降低了术后恶心呕吐和术中低血压的发生率，延长了第一次要求镇痛的时间（统计上，但临床上没有）。然而，当使用右美托咪定镇痛药时，应考虑心动过缓的潜在风险。

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引用次数: 0

Ultrasound-guided peripheral nerve stimulation implantation in the spiral groove. A case report 超声引导下螺旋槽周围神经刺激植入术。一份病例报告。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-01-01 Epub Date: 2025-12-13 DOI: 10.1016/j.redare.2025.501982

J. Mateos-Granados , L.E. Fernández-Rodríguez , M.M. Hernández-García , F. Martínez-Martínez , V. Roqués-Escolar

Neuropathic pain can be treated with peripheral nerve stimulation (PNS), a technique that has become more widespread following the introduction of ultrasound-guided placement. Superficial radial nerve neuropathy is a common disorder, and implanting a PNS device in the distal humeral has been shown to provide good pain control; however, the nerve block test is negative is some patients, and are therefore not candidates for neurostimulation. We report a case of ultrasound-guided implantation of a peripheral nerve stimulator in the spiral groove to treat superficial radial nerve neuropathy. The treatment provided good pain control for more than 1 year, at which time the electrode lead fractured and had to be surgically removed and reimplanted. This may be an effective alternative in certain patients, although further studies are required.

神经性疼痛可以通过外周神经刺激（PNS）来治疗，这是一种随着超声引导放置而变得更加广泛的技术。桡浅神经病变是一种常见的疾病，在肱骨远端植入PNS装置已被证明可以提供良好的疼痛控制；然而，有些患者的神经阻滞试验呈阴性，因此不适合进行神经刺激。我们报告一例超声引导下植入周围神经刺激器在螺旋槽治疗浅桡神经病变。该治疗在1年多的时间内提供了良好的疼痛控制，此时电极导线断裂，必须手术切除并重新植入。这对某些患者可能是一种有效的替代方法，但还需要进一步的研究。

引用次数: 0

Lost in submission? Investigating publication bias in regional anaesthesia: A pilot case study of the erector spinae plane block 屈服了？调查局部麻醉的发表偏倚：竖脊肌平面阻滞的试点案例研究。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-01-01 Epub Date: 2026-01-13 DOI: 10.1016/j.redare.2026.501995

A. De Cassai , B. Dost , Y.E. Karapinar , M.A. Yilmaz , E.I. Turan , E. Sarikaya Ozel

Background

The Erector Spinae Plane (ESP) block is a regional anaesthesia technique with a growing range of clinical applications due to its short learning curve, low complication rate, and effectiveness. However, publication bias can distort the perceived efficacy of interventions, especially when studies with negative or inconclusive results remain unpublished. The real extent of publication bias in ESP-related clinical research currently remains unclear.

Methods

We searched ClinicalTrials.gov on 2 February 2025 using the terms «Erector Spinae Plane Block» and «ESP block», and obtained 671 records. After excluding duplicates, irrelevant, and ongoing studies, 500 records were eventually included. Study characteristics and publication status were determined using a multi-step search strategy that included PubMed®, Scopus®, Embase®, and Central®. Data were analysed using appropriate statistical tests on R (v3.4.0).

Results

Of the 500 studies included, 361 (72.2%) were complete, 102 (20.4%) had unknown status, and 37 (7.4%) had been suspended, terminated, or withdrawn. Only 211 studies (42.2%) were published, and included data from 14,374 of 32,600 intended patients. Published studies were registered significantly earlier than unpublished ones (median year 2020 vs 2021; P = .004). No significant differences were found between published and unpublished studies in terms of main outcome, continent, surgical setting, study design, or sample size.

Conclusions

A substantial proportion of ESP block studies remain unpublished, indicating potential publication bias. Although earlier registration was associated with publication, other study characteristics were not. These findings highlight the need for increased transparency and for clinical trial results to be published regardless of outcome in order to ensure that the evidence base is unbiased.

背景：竖脊平面（ESP）阻滞术是一种局部麻醉技术，由于其学习曲线短、并发症发生率低、效果好等优点，在临床应用中得到越来越广泛的应用。然而，发表偏倚会扭曲干预措施的感知效果，特别是当负面或不确定结果的研究尚未发表时。esp相关临床研究中发表偏倚的真实程度目前尚不清楚。方法：我们于2025年2月2日在ClinicalTrials.gov网站上搜索“Erector Spinae Plane Block”和“ESP Block”，获得了671条记录。在排除重复、不相关和正在进行的研究后，最终纳入了500条记录。使用包括PubMed®、Scopus®、Embase®和Central®在内的多步搜索策略确定研究特征和发表状态。使用R （v3.4.0）对数据进行适当的统计检验。结果：纳入的500项研究中，361项（72.2%）研究完成，102项（20.4%）研究状态未知，37项（7.4%）研究暂停、终止或撤回。只有211项研究（42.2%）被发表，其中包括来自32,600名预期患者中的14,374名患者的数据。已发表研究的注册时间明显早于未发表研究（中位数为2020年vs 2021年；p = 0.004）。已发表的和未发表的研究在主要结局、地区、手术环境、研究设计或样本量方面没有发现显著差异。结论：相当大比例的ESP阻滞研究仍未发表，表明潜在的发表偏倚。虽然早期注册与发表相关，但其他研究特征与发表无关。这些发现强调了提高透明度的必要性，以及无论结果如何都应公布临床试验结果的必要性，以确保证据基础的公正。

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引用次数: 0

GLP1 receptor analogues and perioperative management considerations: A narrative review GLP1受体类似物和围手术期处理考虑：叙述性回顾。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2026-01-01 Epub Date: 2026-01-13 DOI: 10.1016/j.redare.2026.501985

A. Vázquez Lima, M. Vidal Lopo

Glucagon-like peptide type 1 analogues (aGLP1) are a group of drugs capable of stimulating the GLP1 receptor, a key peptide in glycaemic homeostasis through its actions at the pancreatic and gastric level.

This narrative review summarises the possible implications of the perioperative use of this group of drugs. The pancreatic and extrapancreatic effects of aGLP1s determine their anaesthetic implications and perioperative management. The repercussions of their long-term suspension and their effects on the immune system have not yet been sufficiently clarified. The perioperative use of GLP1 agonists is associated with better glycaemic control without a significant increase in complications. However, their use involves a delay in gastric emptying dependent on multiple factors, which may increase the risk of bronchoaspiration.

At present, we can conclude that the perioperative maintenance of GLP1 agonists optimises glycaemic control and avoids disruptions to the potential benefits of treatment without demonstrating an increase in postoperative complications. Delayed gastric emptying and possible bronchoaspiration require measures to minimise risk and ensure patient safety.

胰高血糖素样肽1型类似物（aGLP1）是一组能够刺激GLP1受体的药物，GLP1受体是血糖稳态的关键肽，在胰腺和胃水平上起作用。这篇叙述性综述总结了围手术期使用这组药物的可能含义。aglp1的胰腺和胰腺外作用决定了其麻醉意义和围手术期处理。它们长期停用的影响及其对免疫系统的影响尚未得到充分阐明。围手术期使用GLP1激动剂与更好的血糖控制相关，而不会显著增加并发症。然而，它们的使用涉及依赖于多种因素的胃排空延迟，这可能增加支气管吸入的风险。目前，我们可以得出结论，GLP1激动剂的围手术期维持可以优化血糖控制，避免破坏治疗的潜在益处，而不会增加术后并发症。胃排空延迟和可能的支气管误吸需要采取措施将风险降至最低并确保患者安全。

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引用次数: 0

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