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首页> 外文期刊>Current opinion in anaesthesiology >Anesthetic management for intra-arterial therapy in stroke
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Anesthetic management for intra-arterial therapy in stroke

机译：脑卒中动脉内治疗的麻醉管理

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PURPOSE OF REVIEW: Efforts in intra-arterial treatment of acute ischemic stroke mainly focus on new devices to reperfuse ischemic brain. Equally, if not more important is the anesthesiologists' role in controlling the consciousness level as well as anxiety, movement, airway and respiration and hemodynamic parameters and in a nutshell the safety of patients in a timely manner. We find paucity in studies designed to show the ideal method, level of anesthesia and optimal hemodynamic parameters for these. This review is designed to relate current thought process and debate on the best anesthetic method for this population. RECENT FINDINGS: The primary argument in literature regarding anesthetic management in acute ischemic stroke lies in the sedation level. The ongoing debate is whether general anesthesia is better than local anesthesia with or without sedation. Both sides bring their own argument, which seem legitimate but the bulk of the data are based on retrospective experiences rather than a well designed prospective randomized study. The definition of local vs. general anesthesia is still unclear. Retrospective studies mostly fail to identify cases that had to be converted to general anesthesia, which may influence the outcome. Less has been attributed to the importance of hemodynamic control which seems more important regardless of the anesthetic technique. The potential protective and harmful effect of the anesthetics used needs to be considered as well. SUMMARY: Current literature review on anesthetic considerations of intra-arterial treatment of acute ischemic stroke emphasizes the need for well designed prospective studies to demonstrate the role of anesthetics in brain protection if any as well as define a suitable sedation method and guidelines for hemodynamic parameters.
机译：审查的目的：急性缺血性中风的动脉内治疗的努力主要集中在再灌注缺血性脑的新设备上。同样重要的是，麻醉医师在控制意识水平以及焦虑，运动，气道，呼吸和血液动力学参数以及简而言之及时保护患者安全方面的作用。在旨在显示理想方法，麻醉水平和最佳血流动力学参数的研究中，我们发现缺乏这种研究。这篇综述旨在联系当前的思维过程，并针对该人群的最佳麻醉方法进行辩论。最近的发现：文献中关于急性缺血性中风的麻醉处理的主要论点在于镇静水平。正在进行的辩论是，全身麻醉是否比有镇静的局部麻醉更好。双方都提出了自己的论点，这似乎是合理的，但大部分数据是基于回顾性经验，而不是精心设计的前瞻性随机研究。局部麻醉与全身麻醉的定义仍不清楚。回顾性研究大多未能确定必须转换为全身麻醉的病例，这可能会影响结果。很少有人将其归因于血液动力学控制的重要性，而不论麻醉技术如何，血液动力学控制的重要性似乎都更为重要。还需要考虑所用麻醉剂的潜在保护作用和有害作用。摘要：关于急性缺血性卒中的动脉内治疗的麻醉因素的最新文献综述强调，需要精心设计的前瞻性研究来证明麻醉剂在脑保护中的作用（如果有的话）以及定义合适的镇静方法和血流动力学参数指南。

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