Encuesta nacional sobre la atención anestesiológica perioperatoria en el tratamiento endovascular del ictus isquémico agudo

Kräuchi, O. Romero; Valencia, Lucía; Iturri, F.; Ortega, A. Mariscal; Gómez, A. López; Valero, Ricard

doi:10.1016/j.redar.2017.07.005

Cited by 2 publications

(1 citation statement)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this same study, 16% of anesthesia departments provided only GA services for MT, and did not staff cases under CS (6). Similarly, a study of practices in tertiary stroke centers in Spain revealed that anesthesia for MT was managed by non-anesthesia providers in 21% of the hospitals surveyed (7).…”

Section: Introductionmentioning

confidence: 99%

Monitored Anesthesia Care by Sedation-Trained Providers in Acute Stroke Thrombectomy

et al. 2019

View full text Add to dashboard Cite

Background: Mechanical thrombectomy (MT) for ischemic stroke can be performed under local anesthesia (LA), conscious sedation (CS), or general anesthesia (GA). The need for monitoring by anesthesia providers may be resource intensive. We sought to determine differences in outcomes of MT when sedation is performed by an anesthesia team compared to sedation-trained providers. Methods: We performed a retrospective analysis on patients who were screened by a pre-hospital stroke severity screening tool and underwent MT at two stroke centers. Baseline characteristics, time metrics, sedatives, peri-procedural intubation, complications, and outcomes were recorded. Good outcome was defined as modified Rankin score of ≤2. Results: We analyzed 104 patients (sedation-trained provider = 63, anesthesia team = 41) between July 2015 and December 2017. In the sedation-trained provider group, four patients required intervention by an anesthesia team. There were no differences in patients receiving LA (sedation-trained provider 24% vs. anesthesia team 27% p = 0.82), CS (70 vs. 63%, p = 0.53), or GA (6 vs. 10%, p = 0.71) between groups. Sedation-trained providers were more likely to use only one drug during the procedure (62 vs. 34%, p = 0.009). The rate of procedural complications (9.5 vs. 4.5%, p = 0.48), good outcome (56 vs. 39%, p = 0.11), and mortality (22 vs. 24%, p = 0.82) was similar between groups. Sedation by provider type did not predict functional outcome or mortality at 3 months. Conclusions: Sedation-trained providers are capable of delivering appropriate sedation without compromising patient safety. The use of “as needed” anesthesia teams for MT may have considerable effect on resource allocation and cost.

show abstract

Section: Introductionmentioning

confidence: 99%

Monitored Anesthesia Care by Sedation-Trained Providers in Acute Stroke Thrombectomy

et al. 2019

View full text Add to dashboard Cite

show abstract

Management of Acute Ischemic Stroke in the Interventional Neuroradiology Suite During the COVID-19 Pandemic: A Global Survey

Chowdhury¹,

Rizk

Daniels³

et al. 2020

Journal of Neurosurgical Anesthesiology

View full text Add to dashboard Cite

Background: According to early reports, patients affected by coronavirus disease 2019 (COVID-19) are at an increased risk of developing cerebrovascular events, including acute ischemic stroke (AIS). The COVID-19 pandemic may also impose difficulties in managing AIS patients undergoing endovascular thrombectomy (EVT), as well as concerns for the safety of health care providers. This international global survey aims to gather and summarize information from tertiary care stroke centers on periprocedural pathways and endovascular management of AIS patients during the COVID-19 pandemic. Methods: A cross-sectional survey-based research questionnaire was sent to 259 tertiary care stroke centers with neurointerventional facilities worldwide. Results: We received 114 responses (response rate: 44%) from 25 different countries across all 5 continents. The number of AIS patients and EVT cases were reported to have decreased during the pandemic. Most participants reported conducting COVID-19 testing before (49%) or after the procedure (31%); 20% of centers did not test at all. Only 16% of participating centers reported using a negative pressure room for the thrombectomy procedure. Strikingly, 50% of participating centers reported no changes in the anesthetic management of AIS patients undergoing EVT during the pandemic. Conclusions: This global survey provides information on the challenges in managing AIS patients undergoing EVT during the COVID-19 pandemic. Its findings can be used to improve patient outcomes and the safety of the health care team worldwide.

show abstract

Encuesta nacional sobre la atención anestesiológica perioperatoria en el tratamiento endovascular del ictus isquémico agudo

Cited by 2 publications

References 47 publications

Monitored Anesthesia Care by Sedation-Trained Providers in Acute Stroke Thrombectomy

Monitored Anesthesia Care by Sedation-Trained Providers in Acute Stroke Thrombectomy

Management of Acute Ischemic Stroke in the Interventional Neuroradiology Suite During the COVID-19 Pandemic: A Global Survey

Contact Info

Product

Resources

About