Pub Date : 2025-08-01DOI: 10.1016/j.redare.2025.501772
P. Cruz, A. Puig, E. de la Fuente, S. González, M. Rueda, M. Portas
Tracheal resection surgery for critical stenosis requires a highly specialized and mul-tidisciplinary team, with the primary objectives being adequate airway management, safeventilation, and optimal exposure of the surgical field. This necessitates effective commu-nication and coordination between the anaesthetic and surgical teams.
{"title":"Anesthetic management in critical tracheal stenosis surgery using Tritube® and flow-controlled ventilation: A report of two cases","authors":"P. Cruz, A. Puig, E. de la Fuente, S. González, M. Rueda, M. Portas","doi":"10.1016/j.redare.2025.501772","DOIUrl":"10.1016/j.redare.2025.501772","url":null,"abstract":"<div><div>Tracheal resection surgery for critical stenosis requires a highly specialized and mul-tidisciplinary team, with the primary objectives being adequate airway management, safeventilation, and optimal exposure of the surgical field. This necessitates effective commu-nication and coordination between the anaesthetic and surgical teams.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 7","pages":"Article 501772"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096603","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}
Postoperative delirium (POD) is an adverse outcome that has garnered significant interest in perioperative medicine, particularly in older adults, due to its association with increased morbidity, mortality, and health care costs. In Colombia, this disease is under-reported due to the lack of POD diagnosis and prevention protocols. The aim of this study was to determine the incidence and potential risk factors of POD, and its association with other postoperative complications.
Materials and methods
This retrospective cohort study was performed at a tertiary care hospital. Patients over 60 years of age who underwent surgery between 2012 and 2019 were included. Random sampling was used to analyse electronic medical records to estimate the incidence of POD, risk factors, and postoperative complications within 7 days of surgery.
Results
A total of 2535 patients were evaluated. The cumulative incidence of POD was 6.0% (95% confidence interval [CI]: 5.1%–6.9%), with most cases (67%) occurring within the first 3 postoperative days. Risk factors associated with POD included a history of psychiatric disorders, preoperative opioid use, ASA (American Society of Anesthesiologists) class III/IV, vascular surgery, urgent or emergency surgery, and functional dependency. POD was also associated with higher in-hospital mortality (OR 2.9 [95% CI 1.66–5.07]).
Conclusion
POD is common in patients aged over 60 undergoing surgery, particularly those that undergo urgent or emergency procedures and vascular surgery, who are ASA class > III, functionally dependent, and present psychiatric disorders. POD is also associated with increased postoperative morbidity and mortality.
前言和目的：术后谵妄（POD）是围手术期医学中引起极大兴趣的不良后果，特别是在老年人中，因为它与发病率、死亡率和医疗费用的增加有关。在哥伦比亚，由于缺乏POD诊断和预防方案，该病的报告不足。本研究的目的是确定POD的发生率、潜在危险因素及其与其他术后并发症的关系。材料和方法：本回顾性队列研究在一家三级保健医院进行。在2012年至2019年期间接受手术的60岁以上患者被纳入研究范围。采用随机抽样的方法对电子病历进行分析，估计手术后7天内POD的发生率、危险因素和术后并发症。结果：共评估2535例患者。POD的累积发生率为6.0%(95%可信区间[CI]: 5.1%-6.9%)，大多数病例（67%）发生在术后前3天。与POD相关的危险因素包括精神疾病史、术前阿片类药物使用、ASA（美国麻醉医师协会）III/IV级、血管手术、紧急或紧急手术和功能依赖。POD还与较高的住院死亡率相关（OR为2.9 [95% CI 1.66-5.07]）。结论：POD常见于60岁以上接受手术的患者，特别是那些接受紧急或急诊手术和血管手术的患者，ASA分级b> III，功能依赖，存在精神障碍。POD也与术后发病率和死亡率增加有关。
{"title":"Postoperative delirium in older adults: A retrospective cohort study","authors":"J.A. Vélez-Restrepo , P.A. Betancourt-Ángel , J.D. Caicedo-Jaramillo , F.D. Casas-Arroyave","doi":"10.1016/j.redare.2025.501855","DOIUrl":"10.1016/j.redare.2025.501855","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Postoperative delirium (POD) is an adverse outcome that has garnered significant interest in perioperative medicine, particularly in older adults, due to its association with increased morbidity, mortality, and health care costs. In Colombia, this disease is under-reported due to the lack of POD diagnosis and prevention protocols. The aim of this study was to determine the incidence and potential risk factors of POD, and its association with other postoperative complications.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study was performed at a tertiary care hospital. Patients over 60 years of age who underwent surgery between 2012 and 2019 were included. Random sampling was used to analyse electronic medical records to estimate the incidence of POD, risk factors, and postoperative complications within 7 days of surgery.</div></div><div><h3>Results</h3><div>A total of 2535 patients were evaluated. The cumulative incidence of POD was 6.0% (95% confidence interval [CI]: 5.1%–6.9%), with most cases (67%) occurring within the first 3 postoperative days. Risk factors associated with POD included a history of psychiatric disorders, preoperative opioid use, ASA (American Society of Anesthesiologists) class III/IV, vascular surgery, urgent or emergency surgery, and functional dependency. POD was also associated with higher in-hospital mortality (OR 2.9 [95% CI 1.66–5.07]).</div></div><div><h3>Conclusion</h3><div>POD is common in patients aged over 60 undergoing surgery, particularly those that undergo urgent or emergency procedures and vascular surgery, who are ASA class > III, functionally dependent, and present psychiatric disorders. POD is also associated with increased postoperative morbidity and mortality.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 7","pages":"Article 501855"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251597","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 : 2025-08-01DOI: 10.1016/j.redare.2025.501849
C. Aragón-Benedí , S. Ortega-Lucea , A. Pascual-Bellosta , M. Corcoy-Bidasolo , J. Longas-Vailen , J. Martinez-Ubieto
Background and objectives
Despite the implementation of multimodal rehabilitation programs, postoperative complications are common in some surgeries, and patient recovery is not as rapid as expected. This study was designed to evaluate whether postoperative outcomes can be improved by assessing preoperative functional reserve and frailty on the basis of heart rate variability, specifically Energy (SDNN) and the ANIm (HFnu) value, in patients following prehabilitation programs.
Material and method
Prospective, observational cohort study that will include patients undergoing colorectal oncology surgery within a multimodal rehabilitation program. Patients will be monitored with the ANI device at 2 time points: initial (first pre-anaesthesia consultation, 4 weeks before surgery) and second consultation (1 week before surgery). Data will be collected on heart rate variability, energy, and ANIm values, cardiopulmonary exercise test scores, and other parameters.
Results
We will analyse the correlation between heart rate variability indices and current functional assessment parameters, physiological reserve, and frailty (ASA scale, 6-minute walk test, MUST scale, and Clinical Frailty Scale). Our hypothesis is that higher energy levels (SDNN) will correlate with better postoperative outcomes, fewer complications, and shorter hospital stays.
Conclusions
Statistical analysis will respect all principles of confidentiality and privacy. The results will be published in peer-reviewed journals. This study aims to provide a new tool for assessing frailty and functional reserve in surgical patients as a means of improving prehabilitation programs and postoperative outcomes.
{"title":"Use of heart rate variability to assess functional capacity in multimodal rehabilitation programs in adult surgery: PreANI Study Protocol","authors":"C. Aragón-Benedí , S. Ortega-Lucea , A. Pascual-Bellosta , M. Corcoy-Bidasolo , J. Longas-Vailen , J. Martinez-Ubieto","doi":"10.1016/j.redare.2025.501849","DOIUrl":"10.1016/j.redare.2025.501849","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Despite the implementation of multimodal rehabilitation programs, postoperative complications are common in some surgeries, and patient recovery is not as rapid as expected. This study was designed to evaluate whether postoperative outcomes can be improved by assessing preoperative functional reserve and frailty on the basis of heart rate variability, specifically Energy (SDNN) and the ANIm (HFnu) value, in patients following prehabilitation programs.</div></div><div><h3>Material and method</h3><div>Prospective, observational cohort study that will include patients undergoing colorectal oncology surgery within a multimodal rehabilitation program. Patients will be monitored with the ANI device at 2 time points: initial (first pre-anaesthesia consultation, 4 weeks before surgery) and second consultation (1 week before surgery). Data will be collected on heart rate variability, energy, and ANIm values, cardiopulmonary exercise test scores, and other parameters.</div></div><div><h3>Results</h3><div>We will analyse the correlation between heart rate variability indices and current functional assessment parameters, physiological reserve, and frailty (ASA scale, 6-minute walk test, MUST scale, and Clinical Frailty Scale). Our hypothesis is that higher energy levels (SDNN) will correlate with better postoperative outcomes, fewer complications, and shorter hospital stays.</div></div><div><h3>Conclusions</h3><div>Statistical analysis will respect all principles of confidentiality and privacy. The results will be published in peer-reviewed journals. This study aims to provide a new tool for assessing frailty and functional reserve in surgical patients as a means of improving prehabilitation programs and postoperative outcomes.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 7","pages":"Article 501849"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512965","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 : 2025-08-01DOI: 10.1016/j.redare.2025.501768
R. García Álvarez , F. Ramasco , J. Nieves Alonso , L. Mouriz , P. Rama , I. Bilbao , A. Pérez Carbonell , M.A. Rodenas , F. Ortega , M. Vives , C.A. Calvo , M. Taboada , A. Azzam , M. Merino , F. Martínez , D. Domínguez , C.T. de Llano , R. Adalia , G. Aguilar , C. Aldecoa , G. Hernández
Introduction
In cases of arterial hypotension and/or hypoperfusion that do not respond to fluid therapy, the administration of intravenous catecholamines, especially norepinephrine, is usually the treatment of choice. However, prolonged exposure to high doses of norepinephrine increases mortality, as well as the possibility of arrhythmias, organ damage, and tissue ischemia. An early multimodal vasopressor strategy, which involves adding vasopressin (a drug with a mechanism of action different from catecholamines) to low-dose norepinephrine, could improve the safety profile.
Objectives
The main objective is to characterise the routine clinical practice of vasopressin (VASOPRES) use in the context of shock, collecting clinical, analytical and echocardiographic data.
Materials and methods
The VASOPRES Registry is a prospective multicentre observational study, in which critical care anaesthesia units from all over Spain will participate, collecting data on patients over 18 years of age in whom treatment with vasopressin is initiated, regardless of the type of shock they present. The duration of the study is estimated at 24 months, starting from its approval by the Clinical Research Ethics Committee (CEIm).
Results
Data collection started in July 2024 and is expected to end in July 2026.
Ethics and publications
The Vasopres registry has already been approved by the Clinical Research Ethics Committee of the Hospital Universitario de La Princesa, Madrid (registration number 5596) in May 2024. The study is registered in ClinicalTrials.gov under the number NCT06422975 and in the Spanish Clinical Trials Register (REec) through the GESTO platform (Observational studys with authorized medicines) under the identification number 0083-2024-OBS. The results will be published in specialised journals and presented at conferences and congresses.
Conclusions
The Vasopres Registry may provide insight into the uncertainties that still exist about the use of AVP as well as its use in routine clinical practice in various types of shock. Furthermore, it is also hoped that the results of this study will identify potential areas for improvement where more targeted research is needed.
{"title":"Prospective Multicenter Observational Study of Patients in Shock Treated with Vasopressin: VASOPRES Registry Study Protocol","authors":"R. García Álvarez , F. Ramasco , J. Nieves Alonso , L. Mouriz , P. Rama , I. Bilbao , A. Pérez Carbonell , M.A. Rodenas , F. Ortega , M. Vives , C.A. Calvo , M. Taboada , A. Azzam , M. Merino , F. Martínez , D. Domínguez , C.T. de Llano , R. Adalia , G. Aguilar , C. Aldecoa , G. Hernández","doi":"10.1016/j.redare.2025.501768","DOIUrl":"10.1016/j.redare.2025.501768","url":null,"abstract":"<div><h3>Introduction</h3><div>In cases of arterial hypotension and/or hypoperfusion that do not respond to fluid therapy, the administration of intravenous catecholamines, especially norepinephrine, is usually the treatment of choice. However, prolonged exposure to high doses of norepinephrine increases mortality, as well as the possibility of arrhythmias, organ damage, and tissue ischemia. An early multimodal vasopressor strategy, which involves adding vasopressin (a drug with a mechanism of action different from catecholamines) to low-dose norepinephrine, could improve the safety profile.</div></div><div><h3>Objectives</h3><div>The main objective is to characterise the routine clinical practice of vasopressin (VASOPRES) use in the context of shock, collecting clinical, analytical and echocardiographic data.</div></div><div><h3>Materials and methods</h3><div>The VASOPRES Registry is a prospective multicentre observational study, in which critical care anaesthesia units from all over Spain will participate, collecting data on patients over 18 years of age in whom treatment with vasopressin is initiated, regardless of the type of shock they present. The duration of the study is estimated at 24 months, starting from its approval by the Clinical Research Ethics Committee (CEIm).</div></div><div><h3>Results</h3><div>Data collection started in July 2024 and is expected to end in July 2026.</div></div><div><h3>Ethics and publications</h3><div>The Vasopres registry has already been approved by the Clinical Research Ethics Committee of the Hospital Universitario de La Princesa, Madrid (registration number 5596) in May 2024. The study is registered in ClinicalTrials.gov under the number NCT06422975 and in the Spanish Clinical Trials Register (REec) through the GESTO platform (Observational studys with authorized medicines) under the identification number 0083-2024-OBS. The results will be published in specialised journals and presented at conferences and congresses.</div></div><div><h3>Conclusions</h3><div>The Vasopres Registry may provide insight into the uncertainties that still exist about the use of AVP as well as its use in routine clinical practice in various types of shock. Furthermore, it is also hoped that the results of this study will identify potential areas for improvement where more targeted research is needed.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 7","pages":"Article 501768"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096614","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 : 2025-08-01DOI: 10.1016/j.redare.2025.501770
L. Valero Verche , P. Alfaro de la Torre
{"title":"Comments on \"A pain in the pocket: prevalence of pain in patients with implanted neuromodulation systems: A retrospective study\"","authors":"L. Valero Verche , P. Alfaro de la Torre","doi":"10.1016/j.redare.2025.501770","DOIUrl":"10.1016/j.redare.2025.501770","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 7","pages":"Article 501770"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096609","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 : 2025-08-01DOI: 10.1016/j.redare.2025.501880
L. Monteagudo Moreno , P. Cía Blasco , M. Malo Urriés , A. Nuez Polo , C. Marín Zaldívar
Background and objectives
Neuropathic pain (NP) is a widespread, complex disorder that responds differently to pharmacological treatment. The aim of this study was to identify the baseline characteristics of good response to capsaicin 8% patch in patients with trauma-induced peripheral neuropathic pain (PNP).
Materials and methods
We performed a prospective, longitudinal, open-label study in 31 patients with PNP treated with 1–3 applications of the capsaicin 8% patch for 52 weeks. Response to treatment was defined as a reduction in the Visual Analogue Scale (VAS) score compared to baseline. Data from responders and non-responders were compared at the start (month 1) and end (month 12) of treatment. Logistic regression was used to identify predictors of treatment response.
Results
At month 1, responders (n = 17) had significantly larger treatment areas (155.18 cm2 vs. 59.21 cm2; p = 0.004) and reported greater pain relief with treatments received in the previous week in the brief pain questionnaire (34.7% vs. 14.3%; p = 0.023). At month 12, significant predictors included cold allodynia (OR 8; p = 0.030), positive for painful cold in the DN4 questionnaire (OR 7.936; p = 0.019), no penetrating pain (OR 16.800; p = 0.009), and pain interference with work score <7.5 (OR 7.917; p = 0.019).
Conclusions
This study makes a significant contribution to the management of post-traumatic peripheral neuropathic pain by providing tools to personalise treatment and optimize available resources.
{"title":"Predictors of response in patients with traumatic peripheral neuropathic pain treated with the 8% capsaicin patch","authors":"L. Monteagudo Moreno , P. Cía Blasco , M. Malo Urriés , A. Nuez Polo , C. Marín Zaldívar","doi":"10.1016/j.redare.2025.501880","DOIUrl":"10.1016/j.redare.2025.501880","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Neuropathic pain (NP) is a widespread, complex disorder that responds differently to pharmacological treatment. The aim of this study was to identify the baseline characteristics of good response to capsaicin 8% patch in patients with trauma-induced peripheral neuropathic pain (PNP).</div></div><div><h3>Materials and methods</h3><div>We performed a prospective, longitudinal, open-label study in 31 patients with PNP treated with 1–3 applications of the capsaicin 8% patch for 52 weeks. Response to treatment was defined as a reduction in the Visual Analogue Scale (VAS) score compared to baseline. Data from responders and non-responders were compared at the start (month 1) and end (month 12) of treatment. Logistic regression was used to identify predictors of treatment response.</div></div><div><h3>Results</h3><div>At month 1, responders (<em>n</em> = 17) had significantly larger treatment areas (155.18 cm<sup>2</sup> vs. 59.21 cm<sup>2</sup>; <em>p</em> = 0.004) and reported greater pain relief with treatments received in the previous week in the brief pain questionnaire (34.7% vs. 14.3%; <em>p</em> = 0.023). At month 12, significant predictors included cold allodynia (OR 8; <em>p</em> = 0.030), positive for painful cold in the DN4 questionnaire (OR 7.936; <em>p</em> = 0.019), no penetrating pain (OR 16.800; <em>p</em> = 0.009), and pain interference with work score <7.5 (OR 7.917; <em>p</em> = 0.019).</div></div><div><h3>Conclusions</h3><div>This study makes a significant contribution to the management of post-traumatic peripheral neuropathic pain by providing tools to personalise treatment and optimize available resources.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 7","pages":"Article 501880"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532174","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 : 2025-06-01DOI: 10.1016/j.redare.2025.501729
A.M. Pascual-Bellosta , C. Aragón-Benedí , S.M. Ortega-Lucea , L. Mínguez-Braulio , M. Buey-Aguilar , A. Abad-Gurumeta , E. Tamayo-Gómez , J. Martinez-Ubieto , SIMONE Trial Group
Background and objectives
Nociception monitoring allows for the titration of opioid drugs in the intraoperative period in order to avoid under- and overdosing of these drugs and their side effects in the patient’s postoperative period. For this reason, a study has been designed with the aim of establishing whether the usefulness of the NoL® (Nociception Level) device for adequate intraoperative nociception monitoring can reduce postoperative complications.
Material and methods
Multicentre, observational, prospective cohort study that will include patients who underwent laparoscopic abdominal surgery under balanced general anaesthesia during one year in different hospital centres in order to assess the incidence of early and late postoperative complications and their relationship with the monitoring of nociception studied through the NoL device. Intraoperative pain management will be based on NoL values (visible NoL group) or hemodynamic parameters according to usual clinical practice (non-visible NoL group).
Results
Approval has been obtained from the Autonomous Research Ethics Committee of Aragon (C.I. EPA23/026, 19 April 2023). Simone Studio was registered at www.clinicaltrials.gov on 30 May 2024 (Identifier: NCT06437743).
Conclusions
The overall data will be published in peer-reviewed journals. The relevance of the SIMONE study lies in being the first nationwide to comprehensively evaluate opioid dosing, postoperative pain, early and late postoperative complications, and the length of hospital stay. A significant reduction in the incidence of postoperative complications such as nausea and vomiting is expected in the group with visible NoL monitoring.
{"title":"Monitoring of nociception by NoL Index and its implication in the reduction of opioid complications in laparoscopic abdominal surgery (SIMONE study): Protocol of a prospective, multicentre, observational cohort study","authors":"A.M. Pascual-Bellosta , C. Aragón-Benedí , S.M. Ortega-Lucea , L. Mínguez-Braulio , M. Buey-Aguilar , A. Abad-Gurumeta , E. Tamayo-Gómez , J. Martinez-Ubieto , SIMONE Trial Group","doi":"10.1016/j.redare.2025.501729","DOIUrl":"10.1016/j.redare.2025.501729","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Nociception monitoring allows for the titration of opioid drugs in the intraoperative period in order to avoid under- and overdosing of these drugs and their side effects in the patient’s postoperative period. For this reason, a study has been designed with the aim of establishing whether the usefulness of the NoL® (Nociception Level) device for adequate intraoperative nociception monitoring can reduce postoperative complications.</div></div><div><h3>Material and methods</h3><div>Multicentre, observational, prospective cohort study that will include patients who underwent laparoscopic abdominal surgery under balanced general anaesthesia during one year in different hospital centres in order to assess the incidence of early and late postoperative complications and their relationship with the monitoring of nociception studied through the NoL device. Intraoperative pain management will be based on NoL values (visible NoL group) or hemodynamic parameters according to usual clinical practice (non-visible NoL group).</div></div><div><h3>Results</h3><div>Approval has been obtained from the Autonomous Research Ethics Committee of Aragon (C.I. EPA23/026, 19 April 2023). Simone Studio was registered at <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span> on 30 May 2024 (Identifier: <span><span>NCT06437743</span><svg><path></path></svg></span>).</div></div><div><h3>Conclusions</h3><div>The overall data will be published in peer-reviewed journals. The relevance of the SIMONE study lies in being the first nationwide to comprehensively evaluate opioid dosing, postoperative pain, early and late postoperative complications, and the length of hospital stay. A significant reduction in the incidence of postoperative complications such as nausea and vomiting is expected in the group with visible NoL monitoring.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 6","pages":"Article 501729"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495132","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}
{"title":"Evolution of medical practice: From eminence to artificial intelligence","authors":"H.S. Manzolillo , Á. Espinosa , S. Benitez , J.R. Melchor","doi":"10.1016/j.redare.2025.501804","DOIUrl":"10.1016/j.redare.2025.501804","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 6","pages":"Article 501804"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056210","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 : 2025-06-01DOI: 10.1016/j.redare.2025.501734
M. de la Matta, D. López-Herrera
{"title":"Comments on the article “Mean airway pressure as a parameter of lung-protective and heart-protective ventilation” by Placenti A, Fratebianchi F","authors":"M. de la Matta, D. López-Herrera","doi":"10.1016/j.redare.2025.501734","DOIUrl":"10.1016/j.redare.2025.501734","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 6","pages":"Article 501734"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495129","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 : 2025-06-01DOI: 10.1016/j.redare.2025.501675
E.M. Elemam, I. Abdelbaser, K. Elbahrawy, M.M. Alseoudy, S. El Kenany
Introduction and objectives
US-guided ilioinguinal nerve block (IINB) is a common analgesic regional technique in pediatric inguinal herniotomy, However, alone it could not provide complete analgesia for such surgery due to spare of the genital branch of the genitofemoral nerve (GFN) and some sympathetic fibers. Spermatic cord block (SCB) can block both of them. This study aimed to assess the analgesic effects of combining US-guided spermatic SCB and IINB in pediatric patients subjected to elective open inguinal herniotomies.
Patients and methods
A total of 50 male pediatric patients who underwent inguinal herniotomy were included in the current prospective, randomized, controlled study. Patients were randomly allocated to two groups: one group received IINB and the other received combined IINB and SCB. The number of patients who required rescue analgesia after surgery was the primary outcome parameter, whereas assessment of the intraoperative hemodynamic parameters (MAP: mean arterial pressure; HR: heart rate), total consumption of paracetamol, postoperative pain score, and occurrence of adverse events were the secondary outcome measures.
Results
The number of patients who needed rescue analgesia was significantly lower in IINB/SCB group (12%), than IINB group (41 %), P = 0.025. The median (interquartile range) total dose of paracetamol consumption was significantly lower in the IINB/SCB group [0 (0–0)] mg/kg than in the IINB group [0 (0–10)], P = 0.020. Pain score was significantly (P < 0.05) lower in the IINB/SCB group than in the IINB group at all-time points. Both MAP and HR were significantly higher in the IINB group than in the IINB/SCB group during traction on hernial sac, P < 0.05. Occurrence of adverse events was comparable in both groups.
Conclusions
Adding SCB to IINB can provide better quality of postoperative analgesia and more stable intraoperative hemodynamics in pediatric patients undergoing inguinal hernia repair.
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