[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.

[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.