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J Neurosurg Anesthesiol · Jan 2019
Multicenter StudyOutcomes of Anesthesia Selection in Endovascular Treatment of Acute Ischemic Stroke.
- Yuming Peng, Youxuan Wu, Xiaochuan Huo, Peng Wu, Yang Zhou, Jiaxin Li, Fa Liang, Xiaoyuan Liu, Yuesong Pan, Zhongrong Miao, Ruquan Han, and Endovascular Therapy for Acute Ischemic Stroke Trial (EAST) group.
- Departments of Anesthesiology.
- J Neurosurg Anesthesiol. 2019 Jan 1; 31 (1): 43-49.
BackgroundThe association between anesthesia type and outcomes in patients with acute ischemic stroke undergoing endovascular treatment (EVT) remains a subject of ongoing debate.MethodsThis prospective nonrandomized controlled trial included 149 consecutive patients with acute anterior circulation stroke who underwent EVT. The primary outcome was functional independence assessed by the modified Rankin Scale (mRS) after 3 months.ResultsA total of 105 (70.5%) and 44 (29.5%) patients undergoing EVT who received conscious sedation (CS) and general anesthesia (GA), respectively. The patients who received GA had similar demographics and basic National Institute of Health Stroke Scale scores (17 vs. 16, P>0.05) as the patients who received CS. The recanalization time (304 vs. 311 min, P=0.940) and the recanalization rate (86.4% vs. 84.1%, P=0.170) did not differ between the patients receiving the different types of anesthesia. The National Institute of Health Stroke Scale at 24 hours was lower in the patients who received CS than in those who received GA (β=-2.26, 95% confidence interval, -5.30 to 0.79). The independence (modified Rankin Scale score 0 to 2) at 3 months was equal between patients who received GA and those who received CS (odds ratio=0.73, 95% confidence interval, 0.32-1.68). The mortality and the morbidity rates did not differ.ConclusionsThe data indicated that the selection of GA or CS during EVT had no impact on the independent outcomes of patients with anterior circulation occlusion.
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