缺血性脑血管病(ICVD)是一种严重的健康问题,其中脑组织由于脑血管阻塞而遭受缺氧损伤。机械血栓切除术是治疗这些患者的常用方法。然而,局部麻醉(LA)和清醒镇静(CS)在取栓过程中的作用尚不清楚.我们根据90天改良Rankin量表(mRS)评分评估了两种麻醉方案之间是否存在关系。
■在这项研究中,我们进行了一项回顾性观察性研究,以评估在4个综合性卒中中心的ICVD患者机械取栓期间使用LA和CS的效果.患者分为LA组和CS组。在倾向评分匹配(PSM)分析下进行1:1匹配前后进行统计分析。主要结果指标是90天时mRS评分为0-2。次要结果是手术时间,再通率,有症状和无症状的出血率,和手术并发症。
■共有193例患者(LA患者118例,CS患者75例)纳入PSM前的最终分析。1:1PSM后,98名患者-每组49名患者-被纳入研究。LA和CS应用组之间的临床结果没有差异(p=0.543)。比较血管内治疗(EVT)后随访时的血压(BP)值,CS组的最低收缩压和最低舒张压均较低(p=0.001和p=0.009).两组再通率无显著差异,症状性颅内出血(sICH)率,90天mRS,和手术相关并发症发生率(p=0.617,p=0.274,p=0.543,p=1.000)。
■这项研究没有揭示在90天mRS的EVT期间应用CS的优越性,sICH,再通率,或手术并发症。然而,CS应用期间发生低血压的风险较高.
UNASSIGNED: Ischemic cerebrovascular disease (ICVD) is a serious health problem in which brain tissue suffers from hypoxic damage due to obstruction in cerebral vessels. Mechanical thrombectomy is a commonly used method in the treatment of these patients. However, the effects of local anesthesia (LA) and conscious sedation (CS) during thrombectomy are still unclear. We evaluated whether there was a relationship between the two anesthesia regimens in terms of 90-day modified Rankin Scale (mRS) scores.
UNASSIGNED: In this study, a retrospective observational study was conducted to evaluate the effects of LA and CS used during mechanical thrombectomy in four comprehensive stroke centers among ICVD patients. Patients were divided into the LA group and the CS group. Statistical analysis was performed before and after 1:1 matching under propensity score matching (PSM) analysis. The primary outcome measure was an mRS score of 0-2 at 90 days. Secondary outcomes were procedure times, recanalization rates, symptomatic and asymptomatic hemorrhage rates, and procedural complications.
UNASSIGNED: A total of 193 patients (118 patients with LA and 75 patients with CS) were included in the final analysis before PSM. After 1:1 PSM, 98 patients-49 patients from each group-were included in the study. There was no difference in clinical outcomes between the LA- and CS-applied groups (p = 0.543). When blood pressure (BP) values at follow-up after endovascular treatment (EVT) were compared, the lowest systolic and lowest diastolic BP were found to be lower in the CS group (p = 0.001 and p = 0.009). There was no significant difference between the two groups in terms of recanalization rates, symptomatic intracranial hemorrhage (sICH) rates, 90-day mRS, and procedure-related complication rates (p = 0.617, p = 0.274, p = 0.543, and p = 1.000).
UNASSIGNED: This study did not reveal the superiority of CS applied during EVT on 90-day mRS, sICH, recanalization rates, or procedural complications. However, the risk of developing hypotension during the CS application was found to be high.