Details

Autor(en) / Beteiligte

• Cappellari, Manuel
• Pracucci, Giovanni
• Forlivesi, Stefano
• Saia, Valentina
• Nappini, Sergio
• Nencini, Patrizia
• Inzitari, Domenico
• Greco, Laura
• Sallustio, Fabrizio
• Vallone, Stefano
• Bigliardi, Guido
• Zini, Andrea
• Pitrone, Antonio
• Grillo, Francesco
• Musolino, Rosa
• Bracco, Sandra
• Tinturini, Rebecca
• Tassi, Rossana
• Bergui, Mauro
• Cerrato, Paolo
• Saletti, Andrea
• De Vito, Alessandro
• Casetta, Ilaria
• Gasparotti, Roberto
• Magoni, Mauro
• Castellan, Lucio
• Malfatto, Laura
• Menozzi, Roberto
• Scoditti, Umberto
• Causin, Francesco
• Baracchini, Claudio
• Puglielli, Edoardo
• Casalena, Alfonsina
• Ruggiero, Maria
• Malatesta, Emanuele
• Comelli, Chiara
• Chianale, Gigliola
• Lauretti, Dario Luca
• Mancuso, Michelangelo
• Lafe, Elvis
• Cavallini, Anna
• Cavasin, Nicola
• Critelli, Adriana
• Ciceri, Elisa Francesca Maria
• Bonetti, Bruno
• Chiumarulo, Luigi
• Petruzzelli, Marco
• Giorgianni, Andrea
• Versino, Maurizio
• Ganimede, Maria Porzia
• Tinelli, Angelica
• Auteri, Wiliam
• Petrone, Alfredo
• Guidetti, Giulio
• Nicolini, Ettore
• Allegretti, Luca
• Tassinari, Tiziana
• Filauri, Pietro
• Sacco, Simona
• Pavia, Marco
• Invernizzi, Paolo
• Nuzzi, Nunzio Paolo
• Carmela Spinelli, Maria
• Amistà, Pietro
• Russo, Monia
• Ferrandi, Delfina
• Corraine, Simona
• Craparo, Giuseppe
• Mannino, Marina
• Simonetti, Luigi
• Toni, Danilo
• Mangiafico, Salvatore

Titel

General Anesthesia Versus Conscious Sedation and Local Anesthesia During Thrombectomy for Acute Ischemic Stroke

Ist Teil von

• Stroke (1970), 2020-07, Vol.51 (7), p.2036-2044

Ort / Verlag

United States: American Heart Association, Inc

Erscheinungsjahr

2020

Link zum Volltext

Quelle

EZB Free E-Journals

Beschreibungen/Notizen

• BACKGROUND AND PURPOSE:As numerous questions remain about the best anesthetic strategy during thrombectomy, we assessed functional and radiological outcomes in stroke patients treated with thrombectomy in presence of general anesthesia (GA) versus conscious sedation (CS) and local anesthesia (LA). METHODS:We conducted a cohort study on prospectively collected data from 4429 patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. RESULTS:GA was used in 2013 patients, CS in 1285 patients, and LA in 1131 patients. The rates of 3-month modified Rankin Scale score of 0–1 were 32.7%, 33.7%, and 38.1% in the GA, CS, and LA groupsGA versus CSodds ratios after adjustment for unbalanced variables (adjusted odds ratio [aOR]), 0.811 (95% CI, 0.602–1.091); and GA versus LAaOR, 0.714 (95% CI, 0.515–0.990). The rates of modified Rankin Scale score of 0–2 were 42.5%, 46.6%, and 52.4% in the GA, CS, and LA groupsGA versus CSaOR, 0.902 (95% CI, 0.689–1.180); and GA versus LAaOR, 0.769 (95% CI, 0.566–0.998). The rates of 3-month death were 21.5%, 19.7%, and 14.8% in the GA, CS, and LA groupsGA versus CSaOR, 0.872 (95% CI, 0.644–1.181); and GA versus LAaOR, 1.235 (95% CI, 0.844–1.807). The rates of parenchymal hematoma were 9%, 12.6%, and 11.3% in the GA, CS, and LA groupsGA versus CSaOR, 0.380 (95% CI, 0.262–0.551); and GA versus LAaOR, 0.532 (95% CI, 0.337–0.838). After model of adjustment for predefined variables (age, sex, thrombolysis, National Institutes of Health Stroke Scale, onset-to-groin time, anterior large vessel occlusion, procedure time, prestroke modified Rankin Scale score of <1, antiplatelet, and anticoagulant), differences were found also between GA versus CS as regards modified Rankin Scale score of 0–2 (aOR, 0.659 [95% CI, 0.538–0.807]) and GA versus LA as regards death (aOR, 1.413 [95% CI, 1.095–1.823]). CONCLUSIONS:GA during thrombectomy was associated with worse 3-month functional outcomes, especially when compared with LA. The inclusion of an LA arm in future randomized clinical trials of anesthesia strategy is recommended.