Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Department of Anesthesiology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
J Neurointerv Surg. 2022 Nov;14(11):1073-1076. doi: 10.1136/neurintsurg-2021-018000. Epub 2021 Nov 3.
The best anesthetic management strategy for patients with acute large vessel occlusion treated with mechanical thrombectomy (MT) remains uncertain. Most studies have focused on anterior-circulation stroke caused by large artery occlusion. Nevertheless, limited data are available on the appropriate choice of anesthetic for acute basilar artery occlusion (BAO). We aimed to investigate the effect of anesthetic method on clinical outcomes in patients with BAO undergoing MT.
Patients undergoing MT for acute BAO in the BASILAR registry (Acute Basilar Artery Occlusion Study) were included. We divided patients into three groups according to the anesthetic technique used during MT: general anesthesia (GA), local anesthesia (LA), and conscious sedation (CS). Propensity score matching was performed to achieve baseline balance.
639 patients were included. GA was used in 257 patients (40.2%), LA was used in 250 patients (39.1%), and CS was used in 132 patients (20.7%). After 1:1 matching, favorable outcome, mortality, and hemorrhagic transformation rates, as well as modified Rankin Scale (mRS) score at 90 days, did not differ between the GA, LA, and CS groups.
The choice of anesthetic strategy, GA, LA, or CS, did not affect the clinical outcomes of patients with acute BAO treated with MT in the BASILAR registry.
对于接受机械血栓切除术 (MT) 治疗的急性大血管闭塞患者，最佳的麻醉管理策略仍不确定。大多数研究都集中在前循环卒中引起的大动脉闭塞上。然而，对于急性基底动脉闭塞 (BAO) 患者的适当麻醉选择，可用的数据有限。我们旨在研究麻醉方法对接受 MT 的急性 BAO 患者临床结局的影响。
将 BASILAR 登记处 (急性基底动脉闭塞研究) 中接受 MT 治疗的急性 BAO 患者纳入研究。我们根据 MT 期间使用的麻醉技术将患者分为三组：全身麻醉 (GA)、局部麻醉 (LA) 和镇静 (CS)。采用倾向评分匹配来实现基线平衡。
共纳入 639 例患者。257 例 (40.2%) 使用 GA，250 例 (39.1%) 使用 LA，132 例 (20.7%) 使用 CS。1:1 匹配后，GA、LA 和 CS 组之间的良好结局、死亡率和出血性转化率以及 90 天时的改良 Rankin 量表 (mRS) 评分没有差异。
在 BASILAR 登记处接受 MT 治疗的急性 BAO 患者中，麻醉策略的选择，即 GA、LA 或 CS，并不影响其临床结局。
