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GASS 试验研究方案:一项多中心、单盲、随机临床试验,比较在急性缺血性脑卒中血管内治疗期间全身麻醉与镇静。

GASS Trial study protocol: a multicentre, single-blind, randomised clinical trial comparing general anaesthesia and sedation during intra-arterial treatment for stroke.

机构信息

CHU Rennes, Pôle Anesthésie et Réanimation, Inserm, NuMeCan, CIC 1414 and Université de Rennes 1, Rennes, France.

Department of Neuroradiology, CHU Rennes, Rennes, France.

出版信息

BMJ Open. 2019 Jun 1;9(5):e024249. doi: 10.1136/bmjopen-2018-024249.

Abstract

INTRODUCTION

Treatment of acute stroke has drastically changed in the last 10 years. Endovascular therapy is now the standard of care for patients with a stroke caused by a large vessel occlusion in the anterior circulation. The impact of the type of anaesthesia (general anaesthesia or conscious sedation) during endovascular therapy on the outcome of the patients is still a matter of debate. Previous studies are mostly retrospective and/or focused on the early postprocedure outcome and/or without blood pressure goals and/or single-centre small size studies. We therefore designed a multicentre study hypothesising that conscious sedation is associated with a better functional outcome 3 months after endovascular therapy for the treatment of stroke compared with general anaesthesia.

METHODS/ANALYSIS: The General Anesthesia vs Sedation for Stroke (GASS) Trial is a randomised, parallel, single-blind, multicentre study of 350 patients undergoing endovascular therapy for the treatment of stroke. Patients will be randomly allocated to receive either a general anaesthesia or a conscious sedation. The primary outcome measure is the modified Rankin score assessed 3 months after the treatment. Data will be analysed on the intention-to-treat principle.

ETHICS/DISSEMINATION: The GASS Trial has been approved by an independent ethics committee for all study centres. Participant recruitment begins in September 2016. Results will be published in international peer-reviewed medical journals.

TRIAL REGISTRATION NUMBER

NCT02822144.

摘要

简介

在过去的 10 年中,急性中风的治疗发生了巨大变化。血管内治疗现在是前循环大血管闭塞引起的中风患者的标准治疗方法。在血管内治疗过程中使用的麻醉类型(全身麻醉或清醒镇静)对患者结局的影响仍然存在争议。先前的研究大多是回顾性的,/或侧重于早期术后结果,/或没有血压目标,/或单中心小样本研究。因此,我们设计了一项多中心研究,假设与全身麻醉相比,清醒镇静在血管内治疗中风后的 3 个月时与更好的功能结局相关。

方法/分析:全身麻醉与中风镇静(GASS)试验是一项针对 350 例接受血管内治疗中风的患者进行的随机、平行、单盲、多中心研究。患者将被随机分配接受全身麻醉或清醒镇静。主要结局指标是治疗后 3 个月时评估的改良 Rankin 评分。数据将根据意向治疗原则进行分析。

伦理/发布:GASS 试验已获得所有研究中心的独立伦理委员会的批准。参与者招募于 2016 年 9 月开始。结果将发表在国际同行评议的医学期刊上。

试验注册号

NCT02822144。

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