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Title: | The effect of anesthesia on hemodynamics and outcome of patients undergoing thrombectomy after acute ischemic stroke: a retrospective analysis | Authors: | Ordies, Sofie De Brauwer, Thomas De Beule, Tom VAN POUCKE, Sven Bekelaar, Kim Van Bylen , Ben MESOTTEN, Dieter Luc, Stockx Ernon, Ludovic VAN BOXSTAEL, Sam VANELDEREN, Pascal |
Issue Date: | 2023 | Publisher: | SPRINGER HEIDELBERG | Source: | ACTA NEUROLOGICA BELGICA, | Status: | Early view | Abstract: | Background Anesthesia during thrombectomy remains a matter of debate. We retrospectively investigated the influence of intraprocedural blood pressure and type of anaesthetic agent on 3-month functional outcome and mortality in stroke patients undergoing mechanical thrombectomy under general anesthesia in a single center study.Methods All patients suffering from stroke who presented between January 2019 and July 2021 at Ziekenhuis Oost-Limburg Genk, Belgium and who received thrombectomy were included. Patient's characteristics and outcome data had been collected for benchmarking. Detailed perioperative data were exported from the electronic anesthesia records and clinically validated. Patients were stratified by peri-operative presence of hypotension (MAP < 65 mmHg at any time point) versus no-hypotension (MAP >= 65 mmHg).Results All 98 patients received mechanical thrombectomy under general anesthesia. Thirty-six percent (n = 35) was hypotensive peri-operatively at any time point. Proportion of sevoflurane use was higher in non-hypotensive patients compared to hypotensive patients (73% (n = 45) vs. 51% (n = 18), p = 0.04). Peri-operative use of vasopressors was higher in the hypotensive group compared to non-hypotensive (88% (n = 30) vs. 63% (n = 39), p = 0.008). Proportion of patients with good functional outcome at 3 months (mRS 0-2) was higher in non-hypotensive patients compared to hypotensive patients 44% (n = 27) vs. 24% (n = 8), p < 0.05. 90-day mortality was lower in non-hypotensive patients compared to hypotensive patients 21% (n = 13) vs. 43% (n = 15), (p = 0.02).Conclusion Patients who are hypotensive at any given time during thrombectomy under general anesthesia may have worse neurological outcome compared to non-hypotensive patients. The best anaesthetic management for mechanical thrombectomy needs to be clarified prospectively in large multicenter studies. | Notes: | Ordies, S (corresponding author), Ziekenhuis Oost Limburg, Intens Care Med & Multidisciplinary Pain Ctr, Dept Anaesthesiol, Emergency Med, Genk, Belgium.; Ordies, S (corresponding author), Univ Hosp Leuven, Leuven, Belgium. sofie.ordies@zol.be |
Keywords: | Anesthesia;Hemodynamic monitoring;Hypotension;Stroke | Document URI: | http://hdl.handle.net/1942/41857 | ISSN: | 0300-9009 | e-ISSN: | 2240-2993 | DOI: | 10.1007/s13760-023-02399-4 | ISI #: | 001089609000001 | Rights: | The Author(s) under exclusive licence to Belgian Neurological Society 2023 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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The effect of anesthesia on hemodynamics and outcome of patients undergoing thrombectomy after acute ischemic stroke_ a retrospective analysis.pdf Restricted Access | Early view | 1.48 MB | Adobe PDF | View/Open Request a copy |
DOpsguJLVocZE1gk7kDJ0OqYd53uBr.pdf | Peer-reviewed author version | 660.06 kB | Adobe PDF | View/Open |
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