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首页> 外文期刊>The neurologist. >Does General Anesthesia Compared With Conscious Sedation Result in Better Outcomes in Acute Stroke Patients Undergoing Endovascular Therapy?
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Does General Anesthesia Compared With Conscious Sedation Result in Better Outcomes in Acute Stroke Patients Undergoing Endovascular Therapy?

机译：全身麻醉与有意识的镇静症相比，急性中风患者患血管内治疗的更好的结果吗？

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Background: There is considerable controversy surrounding the optimal use of sedation in patients with acute ischemic stroke undergoing mechanical thrombectomy. Several retrospective studies have favored conscious sedation (CS) over general anesthesia (GA) in terms of functional outcomes and mortality. Recent data from randomized controlled trials has challenged this view. Objective: The aim was to critically assess current evidence regarding the use of CS versus GA in mechanical thrombectomy for acute ischemic stroke. Methods: The objective was addressed through the development of a critically appraised topic that included a clinical scenario, structured question, literature search strategy, critical appraisal, assessment of results, evidence summary, commentary, and bottom-line conclusions. Participants included consultant and resident neurologists, a medical librarian, clinical epidemiologists, and content experts in the field of vascular neurology, vascular neurosurgery, and interventional neuroradiology. Results: A randomized controlled trial was selected for critical appraisal. This trial compared 128 patients with acute ischemic stroke and large vessel occlusion from a single center (Aarhus University Hospital, Denmark), 65 of whom received GA and 63 received CS. No significant difference was detected for the primary outcome of volume of infarct growth. The rate of successful thrombectomy and favorable clinical outcomes for the GA arm was significantly higher in the intention-to-treat analysis. Conclusions: GA does not result in worse tissue outcomes or worse clinical outcomes when compared with CS in acute stroke patients with large vessel occlusion undergoing mechanical thrombectomy.
机译：背景：在接受机械血栓切除术的急性缺血性中风患者中，镇静的最佳使用存在相当大的争议。几项回顾性研究表明，在功能结果和死亡率方面，清醒镇静（CS）优于全麻（GA）。最近来自随机对照试验的数据挑战了这一观点。目的：本研究的目的是批判性地评估在急性缺血性卒中机械血栓切除术中使用CS和GA的现有证据。方法：通过制定一个经过批判性评估的主题，包括临床场景、结构化问题、文献搜索策略、批判性评估、结果评估、证据总结、评论和底线结论，从而实现目标。参与者包括顾问和住院神经学家、医学图书馆员、临床流行病学家，以及血管神经病学、血管神经外科和介入神经放射学领域的内容专家。结果：选择随机对照试验进行批判性评价。该试验比较了来自单个中心（丹麦奥胡斯大学医院）的128名急性缺血性中风和大血管闭塞患者，其中65人接受GA治疗，63人接受CS治疗。梗死生长体积的主要结果无显著差异。在意向治疗分析中，GA组血栓切除术的成功率和良好的临床结果显著较高。结论：在接受机械血栓切除术的大血管闭塞的急性卒中患者中，与CS相比，GA不会导致更差的组织结果或更差的临床结果。

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