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Open Access 02-08-2023 | Local Anesthesia in Dentistry | ORIGINAL RESEARCH

The Functional Prognosis of Rescue Conscious Sedation During Mechanical Thrombectomy on Patients with Acute Anterior Circulation Ischemic Stroke: A Single-Center Retrospective Study

Authors: Shilin Li, Yu Zhang, Xiaobo Zhang, Gejuan Zhang, Nannan Han, Haojun Ma, Hanming Ge, Yong Zhao, Leshi Zhang, Yanfei Wang, Wenzhen Shi, Xiaojuan Ma, Yizhuo Tian, Yixuan Xiao, Yinuo Niu, Lin Qiao, Mingze Chang

Published in: Neurology and Therapy | Issue 5/2023

Abstract

Introduction

Based on real-world case data, this study intends to explore and analyze the impact of rescue conscious sedation (CS) on the clinical outcomes of patients with anterior circulation acute ischemic stroke (AIS) receiving mechanical thrombectomy (MT).

Methods

This retrospective study enrolled patients with anterior circulation AIS who received MT and were treated with either single local anesthesia (LA) or rescue CS during MT between January 2018 and October 2021. We used univariate and multivariate logistic regression methods to compare the impact of LA and CS on the clinical outcomes of patients with AIS who received MT, including the mRS at 90 days, the incidence of poststroke pneumonia (PSP), the incidence of symptomatic intracranial cerebral hemorrhage (sICH), and the mortality rate.

Results

We reviewed 314 patient cases with AIS who received MT. Of all patients, 164 met our search criteria. Eighty-nine patients received LA, and 75 patients received rescue CS. There was no significant difference between the two groups in the 90-day good prognosis (45.3% vs. 51.7%, p = 0.418) and mortality (17.3% vs. 22.5%, p = 0.414). Compared with the LA group, the incidence of postoperative pneumonia in the rescue CS group (44% vs. 25.8%, p = 0.015) was more significant. Multivariate stepwise logistic regression analysis revealed that intraoperative remedial CS was independently associated with PSP following MT. In a subgroup analysis, rescue CS was found to significantly increase the incidence of PSP in patients with dysphagia (OR = 7.307, 95% CI 2.144–24.906, p = 0.001). As the severity of the National Institutes of Health Stroke Scale (NIHSS) increased, intraoperative rescue CS was found to increase the risk of PSP (OR = 1.155, 95% CI 1.034–1.290, p = 0.011) by 5.1% compared to that of LA (OR = 1.104, 95% CI 1.013–1.204, p = 0.024).

Conclusion

Compared to LA, rescue CS during MT does not significantly improve the 90 days of good prognosis and reduce the incidence of sICH and mortality in patients with anterior circulation AIS. However, it has a significantly increased risk of poststroke pneumonia (PSP), particularly in patients with dysphagia.

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Title: The Functional Prognosis of Rescue Conscious Sedation During Mechanical Thrombectomy on Patients with Acute Anterior Circulation Ischemic Stroke: A Single-Center Retrospective Study
Authors: Shilin Li
Yu Zhang
Xiaobo Zhang
Gejuan Zhang
Nannan Han
Haojun Ma
Hanming Ge
Yong Zhao
Leshi Zhang
Yanfei Wang
Wenzhen Shi
Xiaojuan Ma
Yizhuo Tian
Yixuan Xiao
Yinuo Niu
Lin Qiao
Mingze Chang
Publication date: 02-08-2023
Publisher: Springer Healthcare
Keywords: Local Anesthesia in Dentistry
Thrombectomy
Stroke
Dysphagia
Dysphagia
Pneumonia
General Anesthesia
Dysphagia
Published in: Neurology and Therapy / Issue 5/2023
Print ISSN: 2193-8253
Electronic ISSN: 2193-6536
DOI: https://doi.org/10.1007/s40120-023-00528-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Functional Prognosis of Rescue Conscious Sedation During Mechanical Thrombectomy on Patients with Acute Anterior Circulation Ischemic Stroke: A Single-Center Retrospective Study

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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