SwePub
Sök i LIBRIS databas

  Extended search

WFRF:(Pfaff A.)
 

Search: WFRF:(Pfaff A.) > Association of Gene...

  • Schönenberger, Silvia (author)

Association of General Anesthesia vs Procedural Sedation With Functional Outcome Among Patients With Acute Ischemic Stroke Undergoing Thrombectomy: A Systematic Review and Meta-analysis.

  • Article/chapterEnglish2019

Publisher, publication year, extent ...

  • American Medical Association (AMA),2019

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/284316
  • https://gup.ub.gu.se/publication/284316URI
  • https://doi.org/10.1001/jama.2019.11455DOI

Supplementary language notes

  • Language:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • General anesthesia during thrombectomy for acute ischemic stroke has been associated with poor neurological outcome in nonrandomized studies. Three single-center randomized trials reported no significantly different or improved outcomes for patients who received general anesthesia compared with procedural sedation.To detect differences in functional outcome at 3 months between patients who received general anesthesia vs procedural sedation during thrombectomy for anterior circulation acute ischemic stroke.MEDLINE search for English-language articles published from January 1, 1980, to July 31, 2019.Randomized clinical trials of adults with a National Institutes of Health Stroke Scale score of at least 10 and anterior circulation acute ischemic stroke assigned to receive general anesthesia or procedural sedation during thrombectomy.Individual patient data were obtained from 3 single-center, randomized, parallel-group, open-label treatment trials with blinded end point evaluation that met inclusion criteria and were analyzed using fixed-effects meta-analysis.Degree of disability, measured via the modified Rankin Scale (mRS) score (range 0-6; lower scores indicate less disability), analyzed with the common odds ratio (cOR) to detect the ordinal shift in the distribution of disability over the range of mRS scores.A total of 368 patients (mean [SD] age, 71.5 [12.9] years; 163 [44.3%] women; median [interquartile range] National Institutes of Health Stroke Scale score, 17 [14-21]) were included in the analysis, including 183 (49.7%) who received general anesthesia and 185 (50.3%) who received procedural sedation. The mean 3-month mRS score was 2.8 (95% CI, 2.5-3.1) in the general anesthesia group vs 3.2 (95% CI, 3.0-3.5) in the procedural sedation group (difference, 0.43 [95% CI, 0.03-0.83]; cOR, 1.58 [95% CI, 1.09-2.29]; P=.02). Among prespecified adverse events, only hypotension (decline in systolic blood pressure of more than 20% from baseline) (80.8% vs 53.1%; OR, 4.26 [95% CI, 2.55-7.09]; P<.001) and blood pressure variability (systolic blood pressure >180 mm Hg or <120 mm Hg) (79.7 vs 62.3%; OR, 2.42 [95% CI, 1.49-3.93]; P<.001) were significantly more common in the general anesthesia group.Among patients with acute ischemic stroke involving the anterior circulation undergoing thrombectomy, the use of protocol-based general anesthesia, compared with procedural sedation, was significantly associated with less disability at 3 months. These findings should be interpreted tentatively, given that the individual trials examined were single-center trials and disability was the primary outcome in only 1 trial.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Löwhagen Hendén, PiaGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care(Swepub:gu)xlowpi (author)
  • Simonsen, Claus Z (author)
  • Uhlmann, Lorenz (author)
  • Klose, Christina (author)
  • Pfaff, Johannes A R (author)
  • Yoo, Albert J (author)
  • Sørensen, Leif H (author)
  • Ringleb, Peter A (author)
  • Wick, Wolfgang (author)
  • Kieser, Meinhard (author)
  • Möhlenbruch, Markus A (author)
  • Rasmussen, Mads (author)
  • Rentzos, Alexandros,1979Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology(Swepub:gu)xrenta (author)
  • Bösel, Julian (author)
  • Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård (creator_code:org_t)

Related titles

  • In:JAMA: American Medical Association (AMA)322:13, s. 1283-12931538-35980098-7484

Internet link

Find in a library

  • JAMA (Search for host publication in LIBRIS)

To the university's database

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Close

Copy and save the link in order to return to this view