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General anesthesia vs. conscious sedation and local anesthesia for endovascular treatment in patients with posterior circulation acute ischemic stroke: An updated systematic review and meta-analysis.
Fan, Bin; Qiu, Li-Quan; Zhang, Li-Cai; Li, Qiang; Lu, Bin; Chen, Guan-Yu.
Afiliação
  • Fan B; Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, China. Electronic address: fbin2023@163.com.
  • Qiu LQ; Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, China. Electronic address: qiuliquan123456@126.com.
  • Zhang LC; Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, China. Electronic address: 1254473209@qq.com.
  • Li Q; Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, China. Electronic address: 735819032@qq.com.
  • Lu B; Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, China. Electronic address: adghkl123456@163.com.
  • Chen GY; Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, China. Electronic address: 741755319@qq.com.
J Stroke Cerebrovasc Dis ; 33(1): 107471, 2024 Jan.
Article em En | MEDLINE | ID: mdl-37966095
ABSTRACT

INTRODUCTION:

The best anesthetic choice for patients with acute posterior circulation stroke during endovascular treatment (EVT) remains uncertain.

METHOD:

We searched five databases to identify studies that met the inclusion criteria. Our primary outcome measure was functional independence (FI). Secondary outcomes were 3-month mortality, any intracranial hemorrhage (ICH), symptomatic ICH (sICH), successful reperfusion, and procedure- and ventilator-associated complications.

RESULTS:

A total of 10 studies were included in our meta-analysis. No significant differences were detected between the general anesthesia (GA) and conscious sedation and local anesthesia (CS/LA) groups in 3-month FI (nine studies; OR=0.69; 95% CI 0.45-1.06; P=0.083; I2=66%;), 3-month mortality (nine studies; OR=1.41; 95% CI 0.94-2.11; P=0.096; I2=61.2%;), any ICH (three studies; OR=0.75; 95% CI 0.44-1.25; P=0.269; I2=0%;), or sICH (six studies; OR=0.64; 95% CI 0.40-1.04; P=0.073; I2=0%;). No significant differences were observed for successful reperfusion (10 studies; OR=1.17; 95% CI 0.91-1.49; P=0.219; I2=0%;), procedure-related complications (four studies; OR=1.14; 95% CI 0.70-1.87; P=0.603; I2=7.9%;), or respiratory complications (four studies; OR=1.19; 95% CI 0.61-2.32; P=0.616; I2=64.9%;) between the two groups.

CONCLUSIONS:

Our study showed no differences in 3-month FI, 3-month mortality, and successful reperfusion between patients treated with GA and those treated with CS/LA. Additionally, no increased risk of hemorrhagic transformation or pulmonary infection was observed in the CS/LA group. These results indicate that CS/LA may be an EVT option for acute posterior circulation stroke patients.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Isquemia Encefálica / Acidente Vascular Cerebral / Procedimentos Endovasculares / AVC Isquêmico Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Isquemia Encefálica / Acidente Vascular Cerebral / Procedimentos Endovasculares / AVC Isquêmico Idioma: En Ano de publicação: 2024 Tipo de documento: Article