Selection of anesthesia methods in endovascular treatment of acute anterior circulation ischemic stroke

Abstract

Abstract Objective To compare the prognostic effects of two different anesthesia methods on endovascular treatment (EVT) of acute anterior circulation ischemic stroke. Methods We collected 90 cases of patients with acute anterior circulation ischemic stroke who received endovascular treatment, and these patients were randomly divided into general anesthesia (GA) group and conscious sedation (CS) group before operation. We recorded the related parameters of EVT under the two anesthesia methods for comparative study. The main outcome index of this study was a good neurological prognosis after 90 days of EVT. Results In this study, a total of 174 patients with acute ischemic stroke were screened, 90 cases met the inclusion criteria. The 90 cases were randomly divided into GA group and CS group before receiving EVT. Of the 90 cases, 88 cases achieved different degrees of vascular recanalization, and all cases were followed up. There was no significant difference in baseline data, mortality, vascular recanalization, incidence of pneumonia, hospitalization time in ICU, postoperative intracranial hemorrhage, improvement of MRS and NIHSS scores between patients in the two groups. Arterial dissection occurred in 6 cases in CS group and 1 case in GA group, with significant difference. The mean arterial pressure at 10, 20, 30, 60min after anesthesia were different. The time of arterial puncture was different in the two groups, but there was no difference in the time of vascular recanalization. There was no significant difference in neurological function prognosis between patients in the two groups at 90 days. However, there are differences in terms of lung infection, mortality and ICU hospitalization time of elderly patients between the two groups. Conclusion There was no significant difference in neurological prognosis between the two anesthesia methods for 90 days after endovascular treatment of acute anterior circulation ischemic stroke. Conscious sedation was superior to general anesthesia for elderly patients.