Journal of the Portuguese Society of Anesthesiology

Access to Scientific Journals and Partnership between the Portuguese Society and the Brazilian Society of Anesthesiology

2025-07-01T17:03:38+01:00

Article of the Month

2025-06-18T10:24:45+01:00

Post or Perish: SPA’s Presence on Social Media

2025-06-17T20:14:18+01:00

Perspective Article - Not applicable

Abusive self-medication with opioid and non-opioid anesthetic drugs among anesthesia professionals:

2025-03-28T10:50:42+00:00

Introduction: Substance abuse among anesthesiologists is a serious occupational health issue, impacting patient safety and the quality of care provided.
We aimed to identify the prevalence, determinants, and impacts of abusive self-medication with opioid and non-opioid anesthetics among anesthesiologists and propose prevention and monitoring strategies.
Methods: This is an integrative review conducted from February to November 2024 in the PubMed, Scopus, Cochrane, Embase, LILACS, Web of Science, and BVS databases. Screening was performed in Rayyan, and lexical and thematic analyses were conducted using IRAMuTeQ. The quality of studies was assessed using JBI, NOS, SANRA, CASP, and GRADE tools, applied according to each study’s methodology. A total of 20 studies were included, categorized according to patterns of abuse, occupational factors, and professional impacts.
Results: The mean prevalence of opioid and non-opioid abuse among professionals was 42.03 ± 22.03. The most commonly abused opioids were fentanyl and sufentanil, followed by propofol and benzodiazepines. Major associated factors included excessive workload, chronic stress, and occupational exposure, while the consequences encompassed overdose, deterioration of mental health, and increased risk of medical errors. Preventive strategies, such as toxicological screening and rehabilitation programs, demonstrated variable effectiveness, limited by institutional barriers, professional stigma, and regulatory deficiencies.
Conclusion: The findings reveal significant variability in the prevalence of substance abuse among anesthesiologists and the influence of occupational, psychological, and institutional factors. While intervention strategies show potential, they lack robust evidence. There is a pressing need for institutional policies that promote safe environments, reduce stigma, and strengthen preventive actions.

A Prospective Study to Compare Predictive Value of Five Parameters for Difficult Intubation

2025-05-05T16:20:58+01:00

Introduction: Patients undergoing surgery under general anesthesia must have their airways secured and proper breathing and oxygenation. Complications from poor airway control might include aspiration, hypoxemia, airway damage, and even mortality. Therefore, it is crucial to anticipate a challenging airway and intubation to prevent complications. The study aims to develop a simple, easy-to-use predictor with high specificity and sensitivity for predicting difficult intubation. The five parameters being looked at are thyromental height test (TMHT), thyromental distance (TMD), modified Mallampati classification (MPC), neck circumference (NC), and Wilson’s score (WS).
Methods: Five parameters were used to evaluate patients preoperatively for difficult intubation, and an intubation difficulty score was calculated. We calculated and compared the specificity, sensitivity, positive predictive value, negative predictive value, and area under the curve for these five parameters.
Results: The PPV of TMHT was 80%, TMD was 40%, MPC was 34.37%, NC was 26.83%, and MPC was 26.09% respectively. The TMHT showed a specificity of 97.75%, sensitivity of 71.43%, NPV OF 96.44%, and accuracy of 94.80% with an area under the curve was 0.946.
Conclusion: The study found that thyromental height (TMHT) was the best predictor out of all the factors that were looked at. It had the highest sensitivity, PPV, NPV, accuracy, and AUC. Mallampati score (MPC), neck circumference (NC), and Wilson score (WS) demonstrated similar statistical values, but these were of limited diagnostic value. Thyromental distance (TMD) was the least reliable parameter for predicting difficult intubation due to its limited sensitivity.