Revista espanola de anestesiologia y reanimacion最新文献

英文中文

A comparative study of optic nerve sheath diameter and Lung Ultrasound score in healthy and preeclampsia parturients 健康与子痫前期产妇视神经鞘直径及肺超声评分的比较研究。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-10-01 DOI: 10.1016/j.redare.2025.501773

A. Nagpal, M. Pandey, N. Kumar

Background

Complications of preeclampsia include cerebral and pulmonary edema which strongly correlate with optic nerve sheath diameter (ONSD) and lung ultrasound score (LUSS) respectively. This study was conducted to compare ONSD and LUSS in healthy and preeclamptic parturients.

Methods

In this prospective observational analytical study, 35 healthy pregnant women and preeclamptic women each underwent ultrasound assessment for ONSD and LUSS (12 region lung technique). Severity of preeclampsia was noted. ROC analysis was performed to obtain a cutoff value for both ONSD and LUSS to predict complications of preeclampsia. A p-value of <0.05 was considered significant.

Results

Mean ONSD and LUSS were higher in preeclamptic compared to healthy parturients [5.06 ± 0.46 vs 4.24 ± 0.38 mm (p < 0.0001) and [5 (1–12) vs 0 (0–1.5); p value <0.0001], respectively. Mean ONSD in severe pre-eclampsia (5.36 ± 0.32 mm) was significantly higher as compared to mild pre-eclampsia (4.71 ± 0.35 mm; p < 0.0001). Women with severe preeclampsia had a higher LUSS as compared to the mild preclamptics and healthy parturients. However, no difference in ONSD and LUSS between mild preeclamptics and healthy parturients was observed. A mean ONSD of >4.65 mm and LUSS of >2 could predict preeclampsia with a sensitivity of 77.14% and 68.57% and specificity of 91.43% and 85.71% with an AUC of 0.907 and 0.806 respectively.

Conclusion

Both ONSD and LUSS can be used to assess severity and complications of preeclampsia. Early detection can be used to treat, guide fluid therapy and monitor response to treatment.

CTRI registration

CTRI/2019/12/022243 (https://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=37940&EncHid=&userName=). IEC: LHMC/IEC/Thesis/2019/116 dated 29/10/2019.

背景：子痫前期的并发症包括脑水肿和肺水肿，两者分别与视神经鞘直径（ONSD）和肺超声评分（LUSS）密切相关。本研究旨在比较健康和子痫前期产妇的ONSD和LUSS。方法：在这项前瞻性观察性分析研究中，35名健康孕妇和子痫前期妇女分别接受超声检查ONSD和LUSS（12区肺技术）。注意到子痫前期的严重程度。进行ROC分析以获得ONSD和LUSS预测子痫前期并发症的临界值。结果：子痫前期产妇的平均ONSD和LUSS高于正常产妇（5.06±0.46 vs 4.24±0.38 mm）（p = 4.65 mm）， LUSS预测子痫前期的敏感性分别为77.14%和68.57%，特异性分别为91.43%和85.71%，AUC分别为0.907和0.806。结论：ONSD和LUSS可用于评估子痫前期的严重程度和并发症。早期发现可用于治疗，指导液体治疗和监测对治疗的反应。Ctri报名：Ctri /2019/12/022243 （https://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=37940&EncHid=&userName=）。IEC: LHMC/IEC/Thesis/2019/116日期为2019年10月29日。

{"title":"A comparative study of optic nerve sheath diameter and Lung Ultrasound score in healthy and preeclampsia parturients","authors":"A. Nagpal, M. Pandey, N. Kumar","doi":"10.1016/j.redare.2025.501773","DOIUrl":"10.1016/j.redare.2025.501773","url":null,"abstract":"<div><h3>Background</h3><div>Complications of preeclampsia<span> include cerebral and pulmonary edema which strongly correlate with optic nerve sheath diameter (ONSD) and lung ultrasound score (LUSS) respectively. This study was conducted to compare ONSD and LUSS in healthy and preeclamptic parturients.</span></div></div><div><h3>Methods</h3><div>In this prospective observational analytical study, 35 healthy pregnant women and preeclamptic women each underwent ultrasound assessment for ONSD and LUSS (12 region lung technique). Severity of preeclampsia was noted. ROC analysis was performed to obtain a cutoff value for both ONSD and LUSS to predict complications of preeclampsia. A p-value of <0.05 was considered significant.</div></div><div><h3>Results</h3><div>Mean ONSD and LUSS were higher in preeclamptic compared to healthy parturients [5.06 ± 0.46 vs 4.24 ± 0.38 mm (<em>p</em> < 0.0001) and [5 (1–12) vs 0 (0–1.5); p value <0.0001], respectively. Mean ONSD in severe pre-eclampsia (5.36 ± 0.32 mm) was significantly higher as compared to mild pre-eclampsia (4.71 ± 0.35 mm; <em>p</em> < 0.0001). Women with severe preeclampsia had a higher LUSS as compared to the mild preclamptics and healthy parturients. However, no difference in ONSD and LUSS between mild preeclamptics and healthy parturients was observed. A mean ONSD of >4.65 mm and LUSS of >2 could predict preeclampsia with a sensitivity of 77.14% and 68.57% and specificity of 91.43% and 85.71% with an AUC of 0.907 and 0.806 respectively.</div></div><div><h3>Conclusion</h3><div>Both ONSD and LUSS can be used to assess severity and complications of preeclampsia. Early detection can be used to treat, guide fluid therapy and monitor response to treatment.</div></div><div><h3>CTRI registration</h3><div>CTRI/2019/12/022243 (<span><span>https://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=37940&EncHid=&userName=</span><svg><path></path></svg></span>). IEC: LHMC/IEC/Thesis/2019/116 dated 29/10/2019.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 8","pages":"Article 501773"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145209","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}

引用次数: 0

Preliminary study: Changes in systolic volume index during Nuss surgery 初步研究：Nuss手术中收缩容积指数的变化。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-10-01 DOI: 10.1016/j.redare.2025.501726

B. Cabeza Martín, M. García-Navlet, A. Melone, M. Arellano Pulido, E. Sanjuan, M. Hervías

Introduction

The surgical correction of the pectus excavatum (PE) is justified by the progressive cardiopulmonary involvement. There are few studies that analyze the hemodynamic changes during the intraoperative period.

Objectives

To describe the stroke volume index (SVI) changes during the intraoperative with the Nuss technique, through the monitoring of the invasive blood pressure curve (IAP).

Material and methods

A prospective observational study of pediatric patients undergoing Nuss surgery by right video-assisted thoracoscopy (VATS). By analyzing the IAP curve using the FloTrac monitor (Edwars®), the following dynamic parameters were evaluated: stroke volume index (SVI), cardiac index (CI), stroke volume variation (SVV). The dates were collected on 3 occasions: baseline, before bar placement (after preload optimization in search of the target IVS) and after bar placement.

Results

Were included 6 patients aged 14–16 years, 5/6 males. Five of six had cardiac MRI with decreased FEVD (33%–44%), 1/6 with FEVD 53%. At baseline, IVS and CI were decreased, 19−29 ml/lat/m² and 1.1−1.9 L/min/m². Two-Three overloads of volume were performed to reach target IVS (25−35 ml/lat/m²), with an increase of 0%–75%. After the placement of the bar, the IVS was increased by 8%–42% (35−40 ml/lat/m²) with respect to the target IVS, with normalization of the CI (2.5−3.5 L/min/m²).

Conclusions

PE produces compression of the VD, with descent of the IVS. After the placement of the Nuss bar, through the analysis of the IAP, we can objectifield an increase in the IVS and normalization of the CI.

介绍：手术矫正漏斗胸（PE）是合理的进行性心肺累及。对术中血流动力学变化进行分析的研究较少。目的：通过监测有创血压曲线（IAP），描述Nuss技术术中脑卒中容积指数（SVI）的变化。材料与方法：采用右胸腔镜（VATS）对小儿Nuss手术患者进行前瞻性观察研究。通过使用FloTrac监护仪（Edwars®）分析IAP曲线，评估以下动态参数：脑卒中容积指数（SVI）、心脏指数（CI）、脑卒中容积变化（SVV）。数据在3种情况下收集：基线，在bar放置之前（在搜索目标IVS的预加载优化之后）和bar放置之后。结果：纳入6例患者，年龄14 ~ 16岁，男性5/6。5 /6的心脏MRI显示FEVD下降（33-44%），1/6的心脏MRI显示FEVD下降53%。基线时IVS和CI降低，分别为19 ~ 29 ml/lat/m2和1.1 ~ 1.9 L/min/m2。为达到目标IVS (25-35 ml/lat/m2)，进行2 -3次超载，增加0-75%。放置棒后，IVS相对于目标IVS增加8%-42% (35-40 ml/lat/m2)， CI正常化（2.5-3.5 L/min/m2）。结论：PE使VD受压，IVS下降。放置Nuss条后，通过对IAP的分析，我们可以客观地看到IVS的增加和CI的正常化。

{"title":"Preliminary study: Changes in systolic volume index during Nuss surgery","authors":"B. Cabeza Martín, M. García-Navlet, A. Melone, M. Arellano Pulido, E. Sanjuan, M. Hervías","doi":"10.1016/j.redare.2025.501726","DOIUrl":"10.1016/j.redare.2025.501726","url":null,"abstract":"<div><h3>Introduction</h3><div>The surgical correction of the pectus excavatum (PE) is justified by the progressive cardiopulmonary involvement. There are few studies that analyze the hemodynamic changes during the intraoperative period.</div></div><div><h3>Objectives</h3><div>To describe the stroke volume index (SVI) changes during the intraoperative with the Nuss technique, through the monitoring of the invasive blood pressure curve (IAP).</div></div><div><h3>Material and methods</h3><div>A prospective observational study of pediatric patients undergoing Nuss surgery by right video-assisted thoracoscopy (VATS). By analyzing the IAP curve using the FloTrac monitor (Edwars®), the following dynamic parameters were evaluated: stroke volume index (SVI), cardiac index (CI), stroke volume variation (SVV). The dates were collected on 3 occasions: baseline, before bar placement (after preload optimization in search of the target IVS) and after bar placement.</div></div><div><h3>Results</h3><div>Were included 6 patients aged 14–16 years, 5/6 males. Five of six had cardiac MRI with decreased FEVD (33%–44%), 1/6 with FEVD 53%. At baseline, IVS and CI were decreased, 19−29 ml/lat/m<sup>2</sup> and 1.1−1.9 L/min/m<sup>2</sup>. Two-Three overloads of volume were performed to reach target IVS (25−35 ml/lat/m<sup>2</sup>), with an increase of 0%–75%. After the placement of the bar, the IVS was increased by 8%–42% (35−40 ml/lat/m<sup>2</sup>) with respect to the target IVS, with normalization of the CI (2.5−3.5 L/min/m<sup>2</sup>).</div></div><div><h3>Conclusions</h3><div>PE produces compression of the VD, with descent of the IVS. After the placement of the Nuss bar, through the analysis of the IAP, we can objectifield an increase in the IVS and normalization of the CI.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 8","pages":"Article 501726"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133396","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}

引用次数: 0

Feasibility and acceptability of an app for monitoring acute postoperative pain in major outpatient surgery 应用程序监测门诊大手术术后急性疼痛的可行性和可接受性。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-10-01 DOI: 10.1016/j.redare.2025.501854

S. Vitale, M.I. Fábregas Blanco, P. Ricós Bugeda, R. Torruella Turró, H. Fernández Fernández, E. Reñé de Antonio

Introduction

By allowing intensive monitoring of acute postoperative pain (APP), mHealth could be clinically useful in contexts with a high prevalence of moderate to severe APP.

Objective

The primary objective was to evaluate the feasibility and acceptability of an app for monitoring DAP. The secondary objectives were to describe DAP during the first week of the postoperative period, to analyse factors associated with it and to assess adherence and satisfaction with analgesic treatment.

Materials and methods

Observational and prospective study in patients undergoing surgery under major ambulatory surgery (MAS) regimen who reported the intensity of DAP for 7 days with an app. We determined the proportions that agreed to use it and who made trajectories of DAP ≥5 days, the pattern of use of the app and the results. Risk factors associated with DAP were analyzed. Satisfaction with DAP control and adherence to the analgesic regimen were assessed through surveys.

Results

53.4% of patients measured their DAP with the app. The main reason for exclusion was technological limitations (75.1%). An uninterrupted DAP trajectory of ≥5 days was traced in 74.4% of patients and a high prevalence of moderate to severe DAP was observed, as well as a high proportion of patients who adhered little or not at all and were little or not at all satisfied with the analgesic results obtained.

Conclusions

Monitoring DAP with the app used was feasible and accepted by patients. It provided clinically useful information by allowing DAP trajectories to be traced and detecting high proportions of patients with moderate to severe DAP, dissatisfied with the analgesic results obtained and non-compliant with analgesic guidelines.

导语：通过对急性术后疼痛（APP）进行强化监测，移动医疗在中重度APP高发的情况下具有临床应用价值。目的：主要目的是评估应用程序监测DAP的可行性和可接受性。次要目的是描述术后第一周的DAP，分析与之相关的因素，并评估镇痛治疗的依从性和满意度。材料和方法：观察性和前瞻性研究，在大门诊手术（MAS）方案下接受手术的患者中，使用app报告了7天的DAP强度。我们确定了同意使用该应用程序的比例，以及DAP≥5天的轨迹，应用程序的使用模式和结果。分析与DAP相关的危险因素。通过调查评估患者对DAP控制的满意度和对镇痛方案的依从性。结果：53.4%的患者使用app测量DAP，排除的主要原因是技术限制（75.1%）。74.4%的患者追踪到不间断的DAP轨迹≥5天，观察到中重度DAP的高患病率，以及高比例的患者很少或根本没有坚持，对所获得的镇痛效果很少或根本不满意。结论：应用app监测DAP是可行的，且为患者所接受。它提供了临床有用的信息，允许追踪DAP轨迹，并检测出中重度DAP患者的高比例，不满意获得的镇痛结果和不遵守镇痛指南。

{"title":"Feasibility and acceptability of an app for monitoring acute postoperative pain in major outpatient surgery","authors":"S. Vitale, M.I. Fábregas Blanco, P. Ricós Bugeda, R. Torruella Turró, H. Fernández Fernández, E. Reñé de Antonio","doi":"10.1016/j.redare.2025.501854","DOIUrl":"10.1016/j.redare.2025.501854","url":null,"abstract":"<div><h3>Introduction</h3><div>By allowing intensive monitoring of acute postoperative pain (APP), mHealth could be clinically useful in contexts with a high prevalence of moderate to severe APP.</div></div><div><h3>Objective</h3><div>The primary objective was to evaluate the feasibility and acceptability of an app for monitoring DAP. The secondary objectives were to describe DAP during the first week of the postoperative period, to analyse factors associated with it and to assess adherence and satisfaction with analgesic treatment.</div></div><div><h3>Materials and methods</h3><div>Observational and prospective study in patients undergoing surgery under major ambulatory surgery (MAS) regimen who reported the intensity of DAP for 7 days with an app. We determined the proportions that agreed to use it and who made trajectories of DAP ≥5 days, the pattern of use of the app and the results. Risk factors associated with DAP were analyzed. Satisfaction with DAP control and adherence to the analgesic regimen were assessed through surveys.</div></div><div><h3>Results</h3><div>53.4% of patients measured their DAP with the app. The main reason for exclusion was technological limitations (75.1%). An uninterrupted DAP trajectory of ≥5 days was traced in 74.4% of patients and a high prevalence of moderate to severe DAP was observed, as well as a high proportion of patients who adhered little or not at all and were little or not at all satisfied with the analgesic results obtained.</div></div><div><h3>Conclusions</h3><div>Monitoring DAP with the app used was feasible and accepted by patients. It provided clinically useful information by allowing DAP trajectories to be traced and detecting high proportions of patients with moderate to severe DAP, dissatisfied with the analgesic results obtained and non-compliant with analgesic guidelines.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 8","pages":"Article 501854"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145220","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}

引用次数: 0

Anaesthesia management of anterior cervical discectomy and fusion 颈前路椎间盘切除术的麻醉管理及fusión。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-10-01 DOI: 10.1016/j.redare.2025.501801

C. Beltrán Piles, B. Monleón, R. Badenes, D. Tabares, P. Capilla

Anterior Cervical Discectomy and Fusion (ACDF) is a common surgical procedure with positive outcomes, but it is not without potentially serious complications for the patient.

We present the case of a patient who underwent ACDF and was found to have a cervical swelling prior to extubation. After a joint evaluation with the otolaryngology team, a suspicion of laryngeal structure dislocation was raised. A manual repositioning was performed prior to neuromuscular relaxation, and the patient was transferred intubated to the Recovery Unit due to a high risk of upper airway obstruction secondary to edema.

After 24 h of monitoring under scheduled corticosteroid treatment, a planned and safe extubation was carried out, witnessed by the otolaryngology team.

前路颈椎椎间盘切除术和融合术（ACDF）是一种常见的外科手术，具有积极的结果，但对患者来说并非没有潜在的严重并发症。我们提出的情况下，患者接受ACDF，并发现有一个宫颈肿胀之前拔管。在与耳鼻喉科小组联合评估后，怀疑喉结构脱位。在神经肌肉放松之前进行手动重新定位，由于患者继发于水肿的上气道阻塞的高风险，患者被转移到恢复病房。在预定的皮质类固醇治疗下监测24小时后，在耳鼻喉科小组的见证下进行了计划和安全的拔管。

引用次数: 0

Paraparetic variant of Guillain-Barré syndrome after epidural anaesthesia 硬膜外麻醉后格林-巴勒综合征的麻痹变异体。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-10-01 DOI: 10.1016/j.redare.2025.501775

F. Garvayo Fernández, A. López Olid, M. Pascual Salas, A. Sánchez López, L.M. Jiménez Rodriguez, F.J. Redondo Calvo

Epidural procedures are widely used as an analgesic adjunct in various surgeries, allowing for a reduction in the use of opioids and the avoidance of their side effects. According to the third National Audit Project in the United Kingdom, the incidence of serious complications related to epidural puncture is very low. A case is presented of a 66-year-old woman who underwent surgery for ovarian oncological pathology and developed, as a complication of neuroaxial anaesthesia in the postoperative period, a sensory-motor disorder limited to the lower limbs, compatible with the paraparesis variant of Guillain-Barré syndrome.

硬膜外手术在各种手术中广泛用作镇痛辅助手段，可减少阿片类药物的使用并避免其副作用。根据英国第三次国家审计项目，硬膜外穿刺相关的严重并发症发生率非常低。我们报告了一位66岁的女性因卵巢肿瘤病理接受手术，作为术后神经轴麻醉的并发症，她出现了一种局限于下肢的感觉运动障碍，与格林-巴罗综合征的麻痹变型相一致。

引用次数: 0

Ulnar artery Doppler indices, a novel emerging predictor of segmental ulnar sparing after supraclavicular block: A prospective observational study 尺动脉多普勒指数，一种新的预测锁骨上阻滞后尺节段性保留的预测指标：一项前瞻性观察研究。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-10-01 DOI: 10.1016/j.redare.2025.501899

M. Adolf Helmy, M. Medhat Megalaa, H. Mohamed Mamdouh, I.A. Ismail, L. Magdy Milad

Background

Supraclavicular brachial plexus block offers several advantages over general anesthesia, yet segmental ulnar sparing is one of the procedure's key drawbacks. Many parameters were proposed to ascertain segmental ulnar sparing, including thermal imaging and perfusion index. However, none proved optimal; therefore, we aimed to evaluate ulnar artery Doppler indices as a potential predictor of segmental ulnar sparing.

Methods

This prospective observational study was conducted at a tertiary center. To obtain a study power of 90% and an alpha error of 0.05, a minimum sample size of 62 patients was required, with a minimum of 11 patients exhibiting segmental ulnar sparing. Adult patients who received supraclavicular brachial plexus block for hand surgery were included. Each dermatome was assessed in terms of motor and sensory function. An experienced operator performed Doppler examinations at baseline, 10-, 20-, and 30 min following block administration. The primary outcome was the accuracy of the change in PI (ΔPI) in predicting segmental ulnar sparing. Other outcomes included the change in resistive index (ΔRI) and the change in waveform morphology (ΔM) to predict segmental ulnar sparing.

Results

Of the 81 patients assessed for eligibility, 15 were excluded, leaving sixty-six in the final analysis. Eleven of the 66 individuals showed segmental ulnar sparing. ΔPI and ΔRI have been identified as accurate predictors of segmental ulnar sparing with best cut-off values of <8.8% and 12%, respectively. Additionally, ulnar artery Doppler morphological changes from triphasic pattern to a monophasic wave can rule out segmental ulnar sparing with a 100% negative predictive value.

Conclusion

In adult patients undergoing hand surgery using supraclavicular brachial plexus block, Changes of Doppler indices, namely ΔPI, ΔRI, and ΔM, showed good accuracy in predicting segmental ulna preservation. However, the generalizability of our findings is limited by being a single-center study with a relatively small sample size.

背景：锁骨上臂丛阻滞与全身麻醉相比有几个优点，但节段性尺骨保留是该手术的主要缺点之一。提出了许多参数来确定节段性尺骨保留，包括热成像和灌注指数。然而，没有一个被证明是最佳的；因此，我们旨在评估尺动脉多普勒指数作为节段性尺动脉保留的潜在预测指标。方法：本前瞻性观察研究在三级中心进行。为了获得90%的研究效能和0.05的α误差，至少需要62例患者的样本量，其中至少有11例患者表现出节段性尺骨保留。在手外科手术中接受锁骨上臂丛阻滞的成年患者也包括在内。根据运动和感觉功能评估每个皮节。一位经验丰富的操作员在阻滞给药后的基线、10分钟、20分钟和30分钟进行多普勒检查。主要结果是PI变化预测尺节段性保留的准确性（ΔPI）。其他结果包括电阻指数的变化（ΔRI）和波形形态的变化（ΔM），以预测节段性尺骨保留结果：在81例评估合格的患者中，15例被排除，剩下66例进入最终分析。66例患者中有11例尺节段性保留。ΔPI和ΔRI被确定为节段性尺骨保留的准确预测因子，最佳临界值分别< 8.8%和12%。此外，尺动脉多普勒形态学变化从三相模式到单相波可以排除节段性尺动脉保留，100%阴性预测值。结论：在锁骨上臂丛神经阻滞行手外科手术的成年患者中，多普勒指数ΔPI、ΔRI和ΔM的变化对预测节段尺骨保留有较好的准确性。然而，我们的研究结果的普遍性受到单中心研究和相对较小的样本量的限制。

{"title":"Ulnar artery Doppler indices, a novel emerging predictor of segmental ulnar sparing after supraclavicular block: A prospective observational study","authors":"M. Adolf Helmy, M. Medhat Megalaa, H. Mohamed Mamdouh, I.A. Ismail, L. Magdy Milad","doi":"10.1016/j.redare.2025.501899","DOIUrl":"10.1016/j.redare.2025.501899","url":null,"abstract":"<div><h3>Background</h3><div>Supraclavicular brachial plexus block offers several advantages over general anesthesia, yet segmental ulnar sparing is one of the procedure's key drawbacks. Many parameters were proposed to ascertain segmental ulnar sparing, including thermal imaging and perfusion index. However, none proved optimal; therefore, we aimed to evaluate ulnar artery Doppler indices as a potential predictor of segmental ulnar sparing.</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted at a tertiary center. To obtain a study power of 90% and an alpha error of 0.05, a minimum sample size of 62 patients was required, with a minimum of 11 patients exhibiting segmental ulnar sparing. Adult patients who received supraclavicular brachial plexus block for hand surgery were included. Each dermatome was assessed in terms of motor and sensory function. An experienced operator performed Doppler examinations at baseline, 10-, 20-, and 30 min following block administration. The primary outcome was the accuracy of the change in PI (ΔPI) in predicting segmental ulnar sparing. Other outcomes included the change in resistive index (ΔRI) and the change in waveform morphology (ΔM) to predict segmental ulnar sparing.</div></div><div><h3>Results</h3><div>Of the 81 patients assessed for eligibility, 15 were excluded, leaving sixty-six in the final analysis. Eleven of the 66 individuals showed segmental ulnar sparing. ΔPI and ΔRI have been identified as accurate predictors of segmental ulnar sparing with best cut-off values of <8.8% and 12%, respectively. Additionally, ulnar artery Doppler morphological changes from triphasic pattern to a monophasic wave can rule out segmental ulnar sparing with a 100% negative predictive value.</div></div><div><h3>Conclusion</h3><div>In adult patients undergoing hand surgery using supraclavicular brachial plexus block, Changes of Doppler indices, namely ΔPI, ΔRI, and ΔM, showed good accuracy in predicting segmental ulna preservation. However, the generalizability of our findings is limited by being a single-center study with a relatively small sample size.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 8","pages":"Article 501899"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984457","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}

引用次数: 0

Perioperative management of patients on GLP-1 receptor agonist treatment: Risks and recommendations GLP-1受体激动剂治疗患者的围手术期管理：风险和建议。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-10-01 DOI: 10.1016/j.redare.2025.501859

E. Simón Polo, I. Rubio Jiménez, N. Aguirre Ahedo, M. Sanjuán Fernández

引用次数: 0

Suzetrigine as a non-opioid analgesic: Between need and scientific evidence 舒三嗪作为一种非阿片类镇痛药：在需求和科学证据之间。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-10-01 DOI: 10.1016/j.redare.2025.501858

A. Alcántara Montero

引用次数: 0

Comparison of serratus plane and erector spinae plane blocks for postoperative analgesia in unilateral breast surgery 单侧乳房手术后锯肌平面与竖脊肌平面阻滞镇痛的比较。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-10-01 DOI: 10.1016/j.redare.2025.501830

K. Şahin , C. Sayman , S. Kına , A. Surhan Çınar

Objective

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.

Methods

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.

Results

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 min) vs the SPB group (290.3 ± 148.3 min) (p = 0.003). Total tramadol consumption over 24 h 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.

Conclusion

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.

目的：由于筋膜间平面阻滞术操作简单、并发症少，其在术后镇痛中的应用越来越广泛。这项前瞻性、单盲、随机对照研究比较了锯肌平面阻滞（SPB）和竖脊肌平面阻滞（ESPB）对单侧乳房手术患者术后镇痛的疗效。方法：74例ASA I-II型患者，年龄18-65岁，接受选择性单侧乳房手术。排除后，70例患者随机接受SPB （n = 35）或ESPB （n = 35）。两组患者均在超声引导下应用25 mL 0.25%布比卡因进行神经阻滞。记录术后疼痛（采用视觉模拟量表[EVA]评估）、镇痛持续时间、曲马多用量及并发症发生率。结果：两组患者EVA评分差异无统计学意义。然而，ESPB组的镇痛时间（395.6±141.9分钟）明显高于SPB组（290.3±148.3分钟）（p = 0.003）。两组间24小时曲马多总消耗量相似：SPB组为70.9±48.6 mg， ESPB组为70.3±50.5 mg。最小的术后并发症，包括恶心和呕吐，组间无显著差异。结论：SPB和ESPB对单侧乳房手术患者的术后镇痛效果相似，安全可靠。ESPB提供更持久的镇痛，因此提高了术后早期患者的舒适度。

{"title":"Comparison of serratus plane and erector spinae plane blocks for postoperative analgesia in unilateral breast surgery","authors":"K. Şahin , C. Sayman , S. Kına , A. Surhan Çınar","doi":"10.1016/j.redare.2025.501830","DOIUrl":"10.1016/j.redare.2025.501830","url":null,"abstract":"<div><h3>Objective</h3><div>The use of interfascial plane blocks for postoperative analgesia<span> 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.</span></div></div><div><h3>Methods</h3><div><span>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 (</span><em>n</em>  =35). In both groups, nerve blocks were administered under ultrasound guidance with 25      =0.003). Total tramadol consumption over 24h was similar between groups: 70.9±48.6mg in the SPB group and 70.3±50.5<!--> <span>mg in the ESPB group. Minimal postoperative complications, including nausea and vomiting, were noted with no significant difference between groups.</span></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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 8","pages":"Article 501830"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145217","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}

引用次数: 0

Poliomyelitis: The paradigm of an eliminated disease: Sequelae and challenges to eradication. 脊髓灰质炎：已消灭疾病的范例：后遗症和根除的挑战。

Revista espanola de anestesiologia y reanimacion

Pub Date : 2025-09-15 DOI: 10.1016/j.redare.2025.500484

José Tuells, José Antonio Hurtado-Sánchez

Polio represents one of the most emblematic cases in the history of public health. Its greatest impact occurred during the first half of the 20th century, with devastating epidemic outbreaks that caused half a million cases annually with tens of thousands of deaths, in addition to leaving many survivors permanently paralyzed. The scientific community responded in an exemplary manner by studying polio until they developed two effective vaccines: an inactivated vaccine (Salk, 1955) and an attenuated vaccine (Sabin, 1962). A global response was immediately organized based on international cooperation, well-defined immunization strategies, and epidemiological surveillance. The mass vaccination effort carried out since 1988 through the Global Polio Eradication Initiative (GPEI) managed to reduce cases by 99.9%. Currently, the wild polio virus only persists in Afghanistan and Pakistan, and the GPEI's "Eradication Strategy 2022-2026" has been implemented with the hope of certifying its complete eradication in the coming years. Two significant challenges remain: controlling outbreaks caused by vaccine-derived polioviruses and increasing low immunization coverage in certain regions.

小儿麻痹症是公共卫生史上最具代表性的病例之一。它的最大影响发生在20世纪上半叶，毁灭性的流行病爆发，每年造成50万例病例，数万人死亡，此外还使许多幸存者永久瘫痪。科学界以模范的方式作出反应，研究小儿麻痹症，直到研制出两种有效的疫苗：一种灭活疫苗（Salk， 1955年）和一种减毒疫苗（Sabin， 1962年）。根据国际合作、明确的免疫战略和流行病学监测，立即组织了全球应对行动。1988年以来通过全球根除脊髓灰质炎行动开展的大规模疫苗接种工作使病例减少了99.9%。目前，野生脊髓灰质炎病毒仅在阿富汗和巴基斯坦存在，GPEI的“2022-2026年根除战略”已经实施，希望在未来几年内证明其完全根除。仍然存在两项重大挑战：控制由疫苗衍生脊髓灰质炎病毒引起的疫情，以及提高某些地区低免疫覆盖率。

{"title":"Poliomyelitis: The paradigm of an eliminated disease: Sequelae and challenges to eradication.","authors":"José Tuells, José Antonio Hurtado-Sánchez","doi":"10.1016/j.redare.2025.500484","DOIUrl":"10.1016/j.redare.2025.500484","url":null,"abstract":"<p><p>Polio represents one of the most emblematic cases in the history of public health. Its greatest impact occurred during the first half of the 20th century, with devastating epidemic outbreaks that caused half a million cases annually with tens of thousands of deaths, in addition to leaving many survivors permanently paralyzed. The scientific community responded in an exemplary manner by studying polio until they developed two effective vaccines: an inactivated vaccine (Salk, 1955) and an attenuated vaccine (Sabin, 1962). A global response was immediately organized based on international cooperation, well-defined immunization strategies, and epidemiological surveillance. The mass vaccination effort carried out since 1988 through the Global Polio Eradication Initiative (GPEI) managed to reduce cases by 99.9%. Currently, the wild polio virus only persists in Afghanistan and Pakistan, and the GPEI's \"Eradication Strategy 2022-2026\" has been implemented with the hope of certifying its complete eradication in the coming years. Two significant challenges remain: controlling outbreaks caused by vaccine-derived polioviruses and increasing low immunization coverage in certain regions.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"500484"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081795","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Revista espanola de anestesiologia y reanimacion

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀