University of Pittsburgh Medical Center, 3550 Terrace Street, Scaife Hall, Suite 600, Pittsburgh, PA 15213, USA.
200 West Arbor Drive, San Diego, CA 92103, USA.
Anesthesiol Clin. 2021 Mar;39(1):113-125. doi: 10.1016/j.anclin.2020.11.002.
Anesthesiologists provide care to acute and subacute ischemic stroke (IS) patients and stroke survivors in interventional radiology, intensive care, and operating rooms. These encounters will become more frequent following studies that have extended the treatment window from last known well time for fibrinolytic and endovascular thrombectomy (EVT). The number of stroke centers certified to quickly and effectively initiate treatment of IS patients and the number of patients connected to them by telehealth continue to grow. This article reviews IS pathophysiology, assessment, treatment, pathology, and complications; anesthetic management during EVT; perioperative stroke management; and how anesthesia has an impact on patients with prior stroke.
麻醉师为介入放射学、重症监护室和手术室中的急性和亚急性缺血性脑卒中 (IS) 患者和脑卒中幸存者提供护理。在研究将纤维蛋白溶解和血管内血栓切除术 (EVT) 的治疗窗口从最后一次已知的健康时间延长后,这些情况将变得更加频繁。已经获得认证的能够快速有效地为 IS 患者启动治疗的脑卒中中心的数量以及通过远程医疗与他们联系的患者数量继续增长。本文回顾了 IS 的病理生理学、评估、治疗、病理学和并发症;EVT 期间的麻醉管理;围手术期脑卒中管理;以及麻醉对既往脑卒中患者的影响。