Letter to the Director
Anesthesia technique and quality of recovery after laparoscopic cholecystectomy: Case closed?
Técnica anestésica y calidad de la recuperación tras colecistectomía laparoscópica: ¿un caso cerrado?
Department of Anesthesiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
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"tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "416" "paginaFinal" => "417" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L.J. Castro Alves, M.C. Kendall" "autores" => array:2 [ 0 => array:2 [ "nombre" => "L.J." "apellidos" => "Castro Alves" ] 1 => array:4 [ "nombre" => "M.C." "apellidos" => "Kendall" "email" => array:1 [ 0 => "mark.kendall@lifespan.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Anesthesiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Técnica anestésica y calidad de la recuperación tras colecistectomía laparoscópica: ¿un caso cerrado?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with great interest the article of Zaballos et al. in a recent issue of the Journal.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The authors performed a prospective longitudinal cohort study in patients undergoing laparoscopic cholecystectomy, and concluded that the quality of recovery was as favorable in the patients who received desflurane as to those who received total intravenous anesthesia. The authors should be congratulated for performing a well-designed study in an important topic (e.g. quality of recovery) in patients undergoing surgery.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> The current emphasis on the need to improve patient-centered outcomes using non-opioid strategies makes the topic very relevant in perioperative medicine.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Although the study was well conducted, there are some questions that need clarification. First, the authors utilized remifentanil as part of the analgesic regimen; however, they do not report the dose of remifentanil used by each study group. This is important, as high doses of remifentanil can cause hyperalgesia and worsen postoperative recovery. Secondly, variability in pain assessments by nurses has been shown to cause bias in analgesic studies, but the authors did not take this fact into account in their analysis.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Lastly, previous studies on quality of recovery have shown that patients who receive more opioids have worse quality of recovery.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Zaballos et al. reported the opposite to be true, so it would be important for the authors to explain their findings.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We would welcome comments addressing the aforementioned issues, as this would further support the findings of this important study.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Castro Alves LJ, Kendall MC. Técnica anestésica y calidad de la recuperación tras colecistectomía laparoscópica: ¿un caso cerrado? Rev Esp Anestesiol Reanim. 2018;65:416–417.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desflurane versus propofol in post-operative quality of recovery of patients undergoing day laparoscopic cholecystectomy. Prospective, comparative, non-inferiority study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Zaballos" 1 => "A. Reyes" 2 => "J. Etulain" 3 => "C. Monteserín" 4 => "M. Rodríguez" 5 => "E. 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