Your browser doesn't support javascript.
loading
Anesthetic management during endovascular treatment of acute ischemic stroke in the MR CLEAN Registry.
Goldhoorn, Robert-Jan B; Bernsen, Marie Louise E; Hofmeijer, Jeannette; Martens, Jasper M; Lingsma, Hester F; Dippel, Diederik W J; van der Lugt, Aad; Buhre, Wolfgang F F A; Roos, Yvo B W E M; Majoie, Charles B L M; Vos, Jan Albert; Boiten, Jelis; Emmer, Bart; van Oostenbrugge, Robert J; van Zwam, Wim H.
Afiliação
  • Goldhoorn RB; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Bernsen MLE; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Hofmeijer J; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Martens JM; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Lingsma HF; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Dippel DWJ; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • van der Lugt A; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Buhre WFFA; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Roos YBWEM; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Majoie CBLM; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Vos JA; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Boiten J; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • Emmer B; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • van Oostenbrugge RJ; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
  • van Zwam WH; From the Departments of Neurology (R.-J.B.G., R.J.v.O.), Anesthesiology (W.F.F.A.B.), and Radiology (W.H.v.Z.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center; Departments of Radiology (M.L.E.B., J.M.M.) and Neurology (J.H.), Rijnstate Hospital, Arnhem; Department
Neurology ; 94(1): e97-e106, 2020 01 07.
Article em En | MEDLINE | ID: mdl-31806692
OBJECTIVE: To compare outcomes after endovascular treatment (EVT) for acute ischemic stroke with 3 different types of anesthetic management in clinical practice, as anesthetic management may influence functional outcome. METHODS: Data of patients with an anterior circulation occlusion, included in the Dutch nationwide, prospective Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) Registry between March 2014 and June 2016, were analyzed. Patients were divided into 3 groups defined by anesthetic technique performed during EVT: local anesthesia only (LA), general anesthesia (GA), or conscious sedation (CS). Primary outcome was the modified Rankin Scale score at 90 days. To compare functional outcome between groups, we estimated a common odds ratio (OR) with ordinal logistic regression, adjusted for age, sex, prestroke modified Rankin Scale score, baseline NIH Stroke Scale score, collaterals, and time from onset to arrival at intervention center. RESULTS: A total of 1,376 patients were included. Performed anesthetic technique was LA in 821 (60%), GA in 381 (28%), and CS in 174 (13%) patients. Compared to LA, both GA and CS were associated with worse functional outcome on the modified Rankin Scale score at 90 days (GA cORadj 0.75; 95% confidence interval [CI] 0.58-0.97; CS cORadj 0.45; 95% CI 0.33-0.62). CS was associated with worse functional outcome than GA (cORadj 0.60; 95% CI 0.42-0.87). CONCLUSIONS: LA is associated with better functional outcome than systemic sedation in patients undergoing EVT for acute ischemic stroke. Whereas LA had a clear advantage over CS, this was less prominent compared to GA. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with acute ischemic stroke undergoing EVT, LA improves functional outcome compared to GA or CS.
Assuntos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Medicinas Complementares: Medicina_neuralterapeutica Assunto principal: Isquemia Encefálica / Acidente Vascular Cerebral / Procedimentos Endovasculares / Anestesia Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Risk_factors_studies País/Região como assunto: Europa Idioma: En Revista: Neurology Ano de publicação: 2020 Tipo de documento: Article
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Medicinas Complementares: Medicina_neuralterapeutica Assunto principal: Isquemia Encefálica / Acidente Vascular Cerebral / Procedimentos Endovasculares / Anestesia Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Risk_factors_studies País/Região como assunto: Europa Idioma: En Revista: Neurology Ano de publicação: 2020 Tipo de documento: Article