The evaluation of the efficacy and prognosis of conscious sedation in endovascular treatment in acute ischemic stroke

doi:10.3969/j.issn.1006-7795.2023.01.011

Abstract

Abstract: Objective To analyze the effect and impact on prognosis of conscious sedation (CS) and conversion to general anesthesia (CGA) in endovascular treatment of acute ischemic stroke (AIS). Methods A retrospective analysis was conducted on 117 AIS patients who received endovascular therapy in Beijing Chaoyang Hospital, Capital Medical University from January 2021 to December 2021. The patients were divided into 2 groups according to anesthesia methods: CS (n=97) and CGA (n=20). General data, admission National Institutes of Health Stroke Scale (NIHSS), site of occlusion vessels, time course, the technical efficacy of the endovascular procedure in establishing reperfusion, complications and prognosis were compared between the two groups. The 1∶3 propensity score matching was calculated from the patients' base line data, so that the number of CS group was adjusted to 60 and CGA 20. Results The CS group had a significantly shorter time of puncture to recanalization (P=0.007). There was a statistically significant difference in the location of vascular occlusion between the two groups (P=0.017), and the incidence of vertebral artery occlusion was higher in the CGA group. There was no significant difference indoor to puncture(DPT) and postoperative modified thrombolysis in cerebral infarction(mTICI )between two groups (P>0.05). CS group had a significantly lower prevalence of postoperative malignant edema and hypostatic penumbra(P<0.05), and a significantly higher rate of good prognosis (P=0.019). Conclusion In the endovascular treatment of AIS, CS is simple and effective. Compared with CGA patients, it can achieve faster reperfusion and is associated with a better clinical prognosis.

Key words: acute ischemic stroke (AIS), mechanical thrombectomy (MT), dexmedetomidine, conscious sedation (CS), general anesthesia (GA)

CLC Number:

R743.3

Jiang Fucheng, Huang Jyumei, Feng Yuexian, Zhong Hongliang, Jia Jianwen, Yang Hongchao, Liu He, Liu Yang. The evaluation of the efficacy and prognosis of conscious sedation in endovascular treatment in acute ischemic stroke[J]. Journal of Capital Medical University, 2023, 44(1): 72-77.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.01.011

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I1/72

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