ESAIC focused guidelines for the management of the failing epidural during labour epidural analgesia.

Background: Labour epidural analgesia reportedly fails in up to 10 to 25% of cases. A joint taskforce of European Society of Anaesthesiology and Intensive Care (ESAIC) experts was created to develop this focused guideline on the management of failing epidural analgesia in a previously well functioning epidural catheter.

Design: Six clinical questions were defined using a PICO (Population/Intervention/Comparison/Outcome) strategy to conduct a systematic literature search.

National survey on clinical practice in obstetric analgesia in Spain.

Introduction: A national survey was conducted among maternity hospitals nationwide to understand the variability in clinical practice for obstetric analgesia and to reach a consensus on optimal care in the future in Spain.

Materials And Methods: Spanish experts in obstetric anesthesiology designed a survey on the practice of obstetric analgesia during childbirth, following a Delphi process. The survey was sent to 195 Spanish maternity hospitals between April and September 2022 using Google Forms.

Neuropathic component of postoperative pain for predicting post-cesarean chronic pain at three months: a prospective observational study.

Background: Recent investigations have showed that cesarean section (CS) might be a cause of chronic pain, with a consequent decrease in quality of life.

Methods: Prospective observational study in a Spanish tertiary hospital. Main outcome measure was to assess early neuropathic characteristics of pain (DN2 score ≥3) one week after CS as a potential risk factor for post-cesarean section chronic pain (PCSCP) at three months.

Modern approach to an old technique: Narrative revision of techniques used to locate the epidural space.

Since the first description of the epidural technique during the 1920s, the continuous progress of knowledge of the anatomy and physiology of the epidural space has allowed the development of different techniques to locate this space while increasing both the safety and efficacy of the procedure. The most common techniques used today are based on the two main characteristics of the epidural space: the difference in distensibility between the ligamentum flavum and the epidural space, and the existence of negative pressure within the epidural space. However, over recent years, technological advances have allowed the development of new techniques to locate the epidural space based on other physical properties of tissues.

Recommendations on the use of deep neuromuscular blockade by anaesthesiologists and surgeons. AQUILES (Anestesia QUIrúrgica para Lograr Eficiencia y Seguridad) Consensus.

Introduction: Neuromuscular blockade enables airway management, ventilation and surgical procedures. However there is no national consensus on its routine clinical use. The objective was to establish the degree of agreement among anaesthesiologists and general surgeons on the clinical use of neuromuscular blockade in order to make recommendations to improve its use during surgical procedures.

"Do not do" recommendations of the Spanish Society of Anaesthesiology, Critical Care and Pain Therapy. "Commitment to Quality by Scientific Societies" Project.

In April 2013 the Ministry of Health (MSSSI) adopted the project called "Commitment to Quality by Scientific Societies in Spain", in response to social and professional demands for sustainability of the health system. The initiative is part of the activities of the Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System, and is coordinated jointly by the Quality and Cohesion Department, the Aragon Institute of Health Sciences (IACS), and the Spanish Society of Internal Medicine (SEMI). All the scientific societies in Spain have been included in this project, and its main objective is to reduce the unnecessary use of health interventions in order to agree "do not do" recommendations, based on scientific evidence.

Renal Replacement Therapy in Acute Kidney Failure due to Rhabdomyolysis.

Rhabdomyolysis is a syndrome caused by skeletal muscle cells destruction which can occur for many reasons, including prolonged immobilization. The main complication of the syndrome is the development of acute renal failure. Rhabdomyolysis and myoglobinuria are responsible for approximately 5% of all causes of acute renal failure in the USA.

[Reasons residents choose to specialize in anesthesiology and postoperative critical care in the autonomous community of Madrid].

Objectives: Our main objective was to determine the reasons why residents chose to specialize in anesthesiology and postoperative critical care in the autonomous community of Madrid. We also wished to know if prior contact with this specialty influenced their choice, if those who chose it as a second specialization differed from those who were doing a first residency, what expectations the residents had and if they had been met, and if they were satisfied with their training.

Material And Methods: Survey of all residents in anesthesiology and postoperative critical care medicine in the community of Madrid between November 2008 and February 2010.

[Analysis of resident anesthesiologists' difficulties with epidural analgesia for labor and childbirth and complication rates].

Objectives: To analyze the number of attempts to provide an epidural or spinal-epidural block for labor and complication rates when the procedures are performed by resident or staff anesthesiologists.

Material And Methods: Prospective, observational study in all women who asked for epidural or spinal-epidural analgesia for labor and childbirth over a 2-month period.

Results: We enrolled 1097 women.

[Perioperative treatment of a pregnant woman with recent cerebral infarction secondary to noncompaction cardiomyopathy].

Recent-onset noncompaction of the myocardium is a rare but serious entity with uncertain prognosis. Cerebral infarction is among the forms of presentation, and pregnancy and hypercoagulability increase risk. We report the case of a pregnant woman brought to the emergency department with ischemic cerebral infarction.

[Platelet count and hematic punction with epidural block in obstetrics].

Introduction: The reference value for and the significance of mild thrombocytopenia associated with pregnancy remain undetermined, and therefore the timing, validity and meaning of coagulation tests before a regional block may vary.

Objective: To determine whether the incidence of bloody puncture is related to preoperative platelet count performed just before an epidural block, to review the incidence of hemorrhagic complications and to determine whether such complications are related to preoperative platelet count.

Methods: We carried a retrospective study of computer records for 1,168 patients given regional blocks to control pain during labor.

[Cesarean section in an orthotopic liver transplantation patient].

We describe the case of a woman with a functioning orthotopic liver transplant who was receiving cyclosporine treatment. An emergency cesarean section was performed, with epidural analgesia, for prolonged pregnancy and an unfavorable cervix. No complications were recorded either during or after surgery.

[Epidural abscess and regional anesthesia].

An epidural abscess is a rare lesion whose consequences can cause high morbi-mortality, particularly in obstetrics, where it occurs in young, healthy patients. With increased use of regional anesthesia, the incidence of epidural abscess will increase. We therefore review the risk factors, most common etiology and clinical signs, which may be non-specific but are nevertheless suggestive.