• Jian Sun, Fa Liang, Youxuan Wu, Yan Zhao, Zhongrong Miao, Li Zhang, Adrian W Gelb, ChanMatthew T VMTVDepartment of Anaesthesia and Intensive Care, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, PR China., Yuming Peng, Ruquan Han, and CANVAS Pilot Trial Investigators.
• Departments of Anesthesiology.
• J Neurosurg Anesthesiol. 2020 Jan 1; 32 (1): 41-47.

BackgroundThe effect of choice of anesthesia on clinical outcome for endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) remains unclear.MethodsWe conducted a pilot trial of 43 patients with acute anterior circulation ischemic stroke having EVT. Patients were randomly allocated to receive general anesthesia or conscious sedation. We documented the rate of recruitment and rate of conversion from conscious sedation to general anesthesia. In addition, we recorded the change in National Institute of Health stroke scale (NIHSS) on day 7, the rate of successful reperfusion and measured neurological function by certified researchers using modified Rankin Score (mRS 0 to 2) at 90 days.ResultsThe recruitment rate was 31.4% and majority of patients were excluded because of delay in hospital presentation and posterior circulation stroke. The rate of conversion from conscious sedation to general anesthesia was 18.2%. This was primarily related to excessive sedation and uncontrolled movement. Change in NIHSS score, rate of successful reperfusion and functional recovery were similar between groups.ConclusionsIt was feasible to randomize AIS patients receiving either general anesthesia or conscious sedation for EVT.

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