意识镇静和局部麻醉在急性缺血性中风中进行血栓切除术的比较:一个多中心研究
Aysenur Onalan1, Erdem Gurkas1, Cetin Kursad Akpinar2
1Stroke Center, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Türkiye.
Frontiers in neurology
|August 16, 2024
概括
在缺血性脑血管疾病 (ICVD) 机械血栓切除术期间,局部麻醉 (LA) 和有意识镇静 (CS) 显示了类似的结果. 然而,CS与较高的低血压风险有关.
科学领域:
- 神经学 神经学
- 麻醉学 麻醉学
- 心血管研究研究心血管研究
背景情况:
- 缺血性脑血管疾病 (ICVD) 构成严重的健康风险,通常用机械血栓切除术治疗.
- 在此过程中选择麻醉,局部麻醉 (LA) 或有意识镇静 (CS) 仍然不清楚它对患者结果的影响.
研究的目的:
- 在接受ICVD机械血栓切除术的患者中,比较LA与CS的有效性.
- 评估麻醉选择对90天修改的兰金度量 (mRS) 评分和其他程序结果的影响.
主要方法:
- 一项涉及四个综合性中风中心的回顾性观察性研究.
- 倾向性得分匹配 (PSM) 用于比较接受LA和CS的患者.
- 主要结局是90天的mRS得分为0-2;次要结局包括手术时间,再通道,出血和并发症.
主要成果:
- 在LA和CS组之间,临床结果 (包括90天的mRS,再通道化率或并发症率) 没有显著差异.
- 在CS治疗的患者在手术后经历了较低的静缩和放缩血压.
- 在CS组,在手术期间低血压的发病率较高.
结论:
- 意识镇静在90天的mRS,再通道或ICVD机械血栓切除术中的并发症率方面并不比局部麻醉优越.
- 在内血管治疗期间使用有意识镇静时,低血压的风险是值得关注的.
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