[Use of statistics and the accessibility of original articles published in 3 anesthesiology journals]. / Análisis comparativo de tres revistas de anestesiologia en cuanto al uso de la estadística y accesibilidad de los artículos originales publicados.

OBJECTIVES: To determine the use of various statistical analyses and the degree of analysis-dependent and article-dependent accessibility to the reader of publications in anesthesiology journals with impact factors (included in the Science Citation Index) in comparison with Revista Española de Anestesiología y Reanimación. MATERIAL AND METHODS: We analyzed original articles published in 2004 by 3 journals: Anesthesiology, the British Journal of Anaesthesia, and the Revista Españlola de Anestesiología y Reanimación. We found 1214 instances of use of statistics in 386 of the 412 articles analyzed. Twenty-six original articles did not use statistical analyses. RESULTS: Statistics were used in 93.7% of the articles. The mean (SD) number of statistical tests used per article was 3.16 (132). Readers able to understand only descriptive statistics would find only a quarter of the articles' analyses comprehensible in all 3 of the journals studied. A reader familiar with second-level statistics (after the classification of Emerson and Colditz), would have an overall understanding of the analyses in 61.94% of the articles. Such a reader would be able to understand a higher percentage (76.67%) of articles in the Spanish anesthesiology journal. CONCLUSIONS: As a result of marked advances in the use of statistics in anesthesiology journals, readers are seeing more applications of higher-level statistics. Readers must therefore acquire greater knowledge of statistics in order to understand the methods used in original research publications. The results we report for analysis-dependent accessibility show that Revista Española de Anestesiología y Reanimación is easier to understand for readers with knowledge of middle-level statistics. Both Anesthestiology and the British Journal of Anaesthesia publish articles that apply more complex statistical analyses.

Análisis comparativo de tres revistas de Anestesiología en cuanto al uso de la estadística y accesibilidad de los artículos originales publicados / Use of statistics and the accessibility of original articles published in 3 anesthesiology journals

OBJETIVOS: Conocer la utilización de distintas pruebas estadísticas y el grado de accesibilidad análisisdependiente y artículo-dependiente en revistas de impacto en Anestesiología según el Science Citation Index (SCI) en relación con la Revista Española de Anestesiología y Reanimación (REDAR). MATERIAL Y MÉTODOS: Se analizaron los artículos originales publicados durante 2004, en tres revistas seleccionadas: Anesthesiology, British Journal of Anaesthesia y Revista Española de Anestesiología y Reanimación, registrando 1.214 pruebas estadísticas en 386 artículos originales de 412 analizados, ya que 26 originales no utilizaron estadística. RESULTADOS: El porcentaje de artículos con estadística fue del 93,7%. El número de estadísticos total por artículo fue de 3,16 (1,32) [media (desviación estándar)]. DISCUSIÓN: Se aprecia que un lector que sólo comprenda estadística descriptiva, será capaz de entender una cuarta parte de los análisis estadísticos usados en los artículos estudiados, independientemente de la revista estudiada. Un lector familiarizado con estadística de Segundo Nivel (Clasificación de Emerson y Colditz), entenderá globalmente, desde el punto de vista estadístico, el 61,94%, siendo este porcentaje más elevado para REDAR, del 76,67%. CONCLUSIONES: Como consecuencia del gran progreso en la utilización de la estadística en las revistas en Anestesiología, nos encontramos ante un incremento en los últimos años en el uso de estadística de alto nivel. Esta circunstancia obligará a obtener y mejorar los conocimientos sobre estadística para una mejor comprensión de la metodología de los artículos originales de las publicaciones científicas. Los resultados obtenidos respecto de la accesibilidad análisis-dependiente demuestran que la Revista Española de Anestesiología y Reanimación es de más fácil comprensión por lectores con nivel de conocimiento estadístico medio, y que tanto Anesthesiology como British Journal of Anaesthesia publican artículos que usan pruebas de mayor complejidad(AU)

OBJECTIVES: To determine the use of various statistical analyses and the degree of analysis-dependent and article-dependent accessibility to the reader of publications in anesthesiology journals with impact factors (included in the Science Citation Index) in comparison with Revista Española de Anestesiología y Reanimación. MATERIAL AND METHODS: We analyzed original articles published in 2004 by 3 journals: Anesthesiology, the British Journal of Anaesthesia, and the Revista Española de Anestesiología y Reanimación. We found 1214 instances of use of statistics in 386 of the 412 articles analyzed. Twenty-six original articles did not use statistical analyses. RESULTS: Statistics were used in 93.7% of the articles. The mean (SD) number of statistical tests used per article was 3.16 (1.32). Readers able to understand only descriptive statistics would find only a quarter of the articles' analyses comprehensible in all 3 of the journals studied. A reader familiar with second-level statistics (after the classification of Emerson and Colditz), would have an overall understanding of the analyses in 61.94% of the articles. Such a reader would be able to understand a higher percentage (76.67%) of articles in the Spanish anesthesiology journal. CONCLUSIONS: As a result of marked advances in the use of statistics in anesthesiology journals, readers are seeing more applications of higher-level statistics. Readers must therefore acquire greater knowledge of statistics in order to understand the methods used in original research publications. The results we report for analysis-dependent accessibility show that Revista Española de Anestesiología y Reanimación is easier to understand for readers with knowledge of middle-level statistics. Both Anesthesiology and the British Journal of Anaesthesia publish articles that apply more complex statistical analyses(AU)

Estudio comparativo de la respuesta metabólica e inmunológica de la morfina administrada vía subaracnoidea frente a morfina endovenosa para el control del dolor postoperatorio en prostatectomía radical / Metabolic and immune response to spinal vs intravenous morphine for analgesia after radical prostatectomy

OBJETIVO: Estudiar las diferencias en la respuesta endocrino-metabólica e inmunológica asociadas al uso endovenoso o subaracnoideo de la morfina utilizada como analgésico postoperatorio en cirugía de prostatectomía radical. MATERIAL Y MÉTODOS: Estudio prospectivo de 60 pacientes incluidos aleatoriamente en dos grupos: Grupo A(n=30): analgesia postoperatoria con morfina endovenosa. Grupo B (n=30): analgesia postoperatoria con morfina subaracnoidea. Para el estudio de la respuesta inmunológica celular se analizó la evolución de las poblaciones leucocitarias y subpoblaciones linfocitarias en sangre periférica y a nivel del drenaje quirúrgico. Como marcadores de la respuesta metabólica e inmunológica humoral se midieron los niveles de cortisol, ACTH, GH, glucosa e inmunoglobulinas en sangre periférica. RESULTADOS: Ambos grupos presentaron linfopenia en sangre periférica. El grupo tratado con morfina subaracnoidea presentó recuentos de linfocitos CD4 significativamente más bajos en sangre periférica, p<0,05. A nivel local no se encontraron diferencias en la respuesta leucocitaria de ambos grupos. Se encontraron diferencias significativas, p<0,05, en el número de células NK y CD4 a nivel local y el encontrado en sangre periférica. En ambos grupos se encontró inmunosupresión de la respuesta humoral, siendo significativamente mayor, p<0,05 en el grupo tratado con morfina subaracnoidea. La respuesta metabólica fue superior en el grupo tratado con morfina endovenosa. CONCLUSIÓN: El grupo tratado con morfina subaracnoidea presentó una respuesta endocrino-metabólica menor. Aunque la respuesta celular a nivel local fue similar en ambos grupos, la respuesta encontrada a nivel periférico fue distinta, pudiendo ser reflejo de diferentes vías centrales de modulación de la respuesta inflamatoria a estrés

OBJETIVE: To study differences between the endocrine– metabolic and immune cell responses to spinal or intravenous administration of morphine for analgesia after radical prostatectomy. MATERIAL AND METHODS: Prospective study of 60 patients randomized to 2 groups: in group A (n=30) morphine for postoperative analgesia was infused intravenously and in group B (n=30) morphine was infused into the spinal canal. Changes in leukocyte populations and lymphocyte subpopulations in peripheral blood and blood from surgical drains (local) were analyzed to study immune cell response to morphine administration. Cortisol, corticotropin, growth hormone, glucose, and immunoglobulin levels in peripheral blood were measured as indicators of metabolic and humoral immune responses. RESULTS: Both groups developed lymphopenia in peripheral blood. The group treated with spinal morphine had significantly lower CD4+ cell counts in peripheral blood P<0.05. No differences were found in the local leukocyte response in either group. Significant differences were found in natural killer and CD4+ cell counts both locally and in peripheral blood P<0.05. There was humoral immune response suppression in both groups; however, it was more marked in the group treated with spinal morphine and the difference was significant P<0.05. The metabolic response was greater in the group treated with intravenous morphine. CONCLUSION: Patients who received morphine by spinal infusion had a less marked endocrine-metabolic response. Although local cell responses were similar in the 2 groups, the response in peripheral blood was different, possibly reflecting different mechanisms of central modulation of the inflammatory response to stress

[Metabolic and immune response to spinal vs intravenous morphine for analgesia after radical prostatectomy]. / Estudio comparativo de la respuesta metabólica e inmunológica de la morfina administrada vía subaracnoidea frente a morfina endovenosa para el control del dolor postoperatorio en prostatectomía radical.

OBJECTIVE: To study differences between the endocrine-metabolic and immune cell responses to spinal or intravenous administration of morphine for analgesia after radical prostatectomy. MATERIAL AND METHODS: Prospective study of 60 patients randomized to 2 groups: in group A (n=30) morphine for postoperative analgesia was infused intravenously and in group B (n=30) morphine was infused into the spinal canal. Changes in leukocyte populations and lymphocyte subpopulations in peripheral blood and blood from surgical drains (local) were analyzed to study immune cell response to morphine administration. Cortisol, corticotropin, growth hormone, glucose, and immunoglobulin levels in peripheral blood were measured as indicators of metabolic and humoral immune responses. RESULTS: Both groups developed lymphopenia in peripheral blood. The group treated with spinal morphine had significantly lower CD4+ cell counts in peripheral blood P<0.05. No differences were found in the local leukocyte response in either group. Significant differences were found in natural killer and CD4+ cell counts both locally and in peripheral blood P<0.05. There was humoral immune response suppression in both groups; however, it was more marked in the group treated with spinal morphine and the difference was significant P<0.05. The metabolic response was greater in the group treated with intravenous morphine. CONCLUSION: Patients who received morphine by spinal infusion had a less marked endocrine-metabolic response. Although local cell responses were similar in the 2 groups, the response in peripheral blood was different, possibly reflecting different mechanisms of central modulation of the inflammatory response to stress.

[Comparison of 4 techniques for general anesthesia for carotid endarterectomy: inflammatory response, cardiocirculatory complications, and postoperative analgesia]. / Estudio comparativo de cuatro técnicas de anestesia general en endarterectomía carotídea: respuesta inflamatoria, complicaciones cardiocirculatorias y analgesia postoperatoria.

OBJECTIVE: [corrected] To study the analgesia, hemodynamic stability and inflammatory response in patients undergoing carotid endarterectomy under different types of general anesthesia. MATERIALS AND METHODS: A comparison of 80 patients randomized to 4 groups: group 1, maintenance with sevoflurane at a minimum alveolar concentration (MAC) of 1; group 2, sevoflurane at MAC 1.5; group 3, remifentanil; group 4, propofol. Variables studied were hemodynamic alterations during and after surgery, level of postoperative analgesia, differential white cell counts, levels of interleukin-6 (IL-6), and clinical signs and symptoms of systemic inflammatory response syndrome in the first 24 hours after surgery. RESULTS: The incidences of episodes of intraoperative hypertension were 60% in group 1, 65% in group 2, 50% in group 3, and 60% in group 4. The incidences of episodes of intraoperative hypotension were 85% in group 1, 80% in group 2, 80% in group 3, and 75% in group 4. Patients in groups 3 and 4 had higher incidences of systemic inflammatory response syndrome (p<0.05) in the first 24 hours after surgery and higher levels of IL-6 (p<0.05). Postoperative analgesia was similar in all 4 groups. CONCLUSIONS: Increased levels of IL-6 in peripheral blood and of systemic inflammatory response syndrome were found in the early postoperative period in groups that did not receive halogenated gases. Hemodynamic stability and analgesia were similar in all groups, however.