Nonoperating Room Anesthesia for Interventional Neuroangiographic Procedures: Outcomes of 105 Patients

Kılıç, Yeliz; Baş, Sema Şanal; Aykaç, Özlem; Özdemi̇r, Atilla Özcan

doi:10.1016/j.jstrokecerebrovasdis.2019.104495

Cited by 3 publications

(4 citation statements)

References 20 publications

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“…The use of supraglottic airway devices, such as laryngeal airway masks (LMA), in EVTs has not been widely explored and remains a novel approach for select patients [21]. LMAs should allow for more hemodynamic stability and smoother emergence, although Kiliç et al [22] reported general anesthesia with LMA had higher rates of hemodynamic changes and respiratory complications compared with general anesthesia with an endotracheal tube. The use of supraglottic airway devices should be discussed with the neuro-intensivist and may be considered in low-risk patients and in cases with shorter estimated procedure time [22].…”

Section: Anesthetic Techniquementioning

confidence: 99%

Anesthetic Management of Acute Ischemic Stroke in the Interventional Neuro-Radiology Suite: State of the Art

Sou¹,

Aglio²,

Zhou³

2021

Current Opinion in Anaesthesiology

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Purpose of reviewThis review discusses the general anesthetic approach of endovascular stroke therapy and highlights recent advances and considerations for optimal intraoperative management of acute ischemic stroke. Recent findingsRecent randomized controlled trials have shown no differences in clinical outcomes between monitored anesthesia care with sedation compared with general anesthesia for endovascular stroke therapy. The COVID-19 pandemic has complicated decision-making in the neurointerventional setting. Advances in imaging techniques have extended the window of treatment for endovascular therapy.

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Section: Anesthetic Techniquementioning

confidence: 99%

Anesthetic Management of Acute Ischemic Stroke in the Interventional Neuro-Radiology Suite: State of the Art

Sou¹,

Aglio²,

Zhou³

2021

Current Opinion in Anaesthesiology

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“…However, the risk of aspiration and substantial movement during endovascular procedural are the main two disadvantages associated with CS. [13][14][15][16][17] Three randomised controlled trials have compared the neurological outcomes after EVT with GA or CS in anterior circulation. The Sedation versus Intubation for Endovascular Stroke TreAtment (SIESTA) trial reported similar National Institute of Health Stroke Scale (NIHSS) scores at 24 hours between GA and CS, but favourable outcomes, measured by modified Rankin Scale (mRS) was found in patients with GA 3 months after treatment as a secondary outcome measure.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Choice of ANaesthesia for EndoVAScular treatment of acute ischaemic stroke at posterior circulation (CANVAS II): protocol for an exploratory randomised controlled study

et al. 2020

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IntroductionObservational and interventional studies indicate that the type of anaesthesia may be associated with the postprocedural neurological function in patients with anterior circulation acute ischaemic stroke undergoing endovascular treatment. Patients with acute posterior circulation ischaemic stroke may experience different physiological changes and result in severe neurological outcome. However, the effect of the type of anaesthesia on postprocedure neurological function remained unclear in this population.Methods and analysisThis is an exploratory randomised controlled trial that will be carried out at Beijing Tiantan Hospital, Capital Medical University. Patients with acute posterior circulation ischaemic stroke and deemed suitable for emergency endovascular recanalisation will be recruited in this trial. Eighty-four patients will be randomised to receive either general anaesthesia or conscious sedation with 1:1 allocation ratio. The primary endpoint is the 90-day modified Rankin Scale.Ethics and disseminationThe study has been reviewed by and approved by Ethics Committee of Beijing Tiantan Hospital of Capital Medical University (KY2017-074-02). If the results are positive, the study will indicate whether the type of anaesthesia affects neurological outcome after endovascular treatment of posterior stroke. The findings of the study will be published in peer-reviewed journals and presented at national or international conferences.Trial registration numberNCT03317535.

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“…4,5 The wide application of antibacterial drugs has changed the types of pathogenic bacteria that can invade the lower respiratory tract; the number of drugresistant pathogen strains has gradually increased together with the level of drug resistance, and multidrug-resistant strains have appeared, bringing great challenges to clinical treatment. 6 In recent years, with accelerated growth of the global aging population, the number of older patients undergoing surgical treatment has been increasing each year. 7 General anesthesia with tracheal intubation has the advantages of safe and effective management.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 The wide application of antibacterial drugs has changed the types of pathogenic bacteria that can invade the lower respiratory tract; the number of drug-resistant pathogen strains has gradually increased together with the level of drug resistance, and multidrug-resistant strains have appeared, bringing great challenges to clinical treatment. 6…”

Section: Introductionmentioning

confidence: 99%

Factors influencing lower respiratory tract infection in older patients after general anesthesia

Chen

Yasen

et al. 2021

J Int Med Res

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Objective Pulmonary complication is common in older patients after surgery. We analyzed risk factors of lower respiratory tract infection after general anesthesia among older patients. Methods In this retrospective investigation, we included older patients who underwent surgery with general anesthesia. Logistic regression analyses were performed to determine risk factors of lower respiratory tract infection. Results A total 418 postoperative patients with general anesthesia were included; the incidence of lower respiratory tract infection was 9.33%. Ten cases were caused by gram-positive bacteria, 26 cases by gram-negative bacteria, and 2 cases by fungus. We found significant differences in age, smoking, diabetes, oral/nasal tracheal intubation, and surgery duration. Logistic regression analysis indicated that age ≥70 years (odds ratio [OR] 2.028, 95% confidence interval [CI] 1.115–3.646), smoking (OR 2.314, 95% CI 1.073–4.229), diabetes (OR 2.185, 95% CI 1.166–4.435), nasotracheal intubation (OR 3.528, 95% CI 1.104–5.074), and duration of surgery ≥180 minutes (OR 1.334, 95% CI 1.015–1.923) were independent risk factors of lower respiratory tract infections. Conclusions Older patients undergoing general anesthesia after tracheal intubation have a high risk of lower respiratory tract infections. Clinical interventions should be provided to prevent pulmonary infections in patients with relevant risk factors.

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Nonoperating Room Anesthesia for Interventional Neuroangiographic Procedures: Outcomes of 105 Patients

Cited by 3 publications

References 20 publications

Anesthetic Management of Acute Ischemic Stroke in the Interventional Neuro-Radiology Suite: State of the Art

Anesthetic Management of Acute Ischemic Stroke in the Interventional Neuro-Radiology Suite: State of the Art

Choice of ANaesthesia for EndoVAScular treatment of acute ischaemic stroke at posterior circulation (CANVAS II): protocol for an exploratory randomised controlled study

Factors influencing lower respiratory tract infection in older patients after general anesthesia

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