@article {Campbell10.1212 / WNL。0000000000207066,作者={坎贝尔,道格拉斯和巴特勒,爱丽丝和坎贝尔,Ruby布莱斯和Ho杰斯和理发师,p . Alan}, title ={全身麻醉相比,在血管内血栓切除术Non-GA缺血性中风:系统回顾和荟萃分析的随机对照试验},elocation-id = {10.1212 / WNL。={2023}0000000000207066},年,doi = {10.1212 / WNL。出版商0000000000207066}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和objectivesEndovascular血栓切除术(EVT)大血管闭半岛投注体育官网塞缺血性中风是在全身麻醉下进行(GA)或与non-GA技术如有意识的镇静(CS)或局部麻醉(LA)。先前的小荟萃分析显示优越的血管再通率和提高功能恢复与GA相比,non-GA技术。进一步相关的出版物可以提供指导在选择GA和non-GA技术更新。MethodsA系统搜索试验中风EVT患者随机遗传算法或执行non-GA Medline、Embase和Cochrane中央登记的对照试验。使用随机效应模型的系统回顾和荟萃分析。ResultsSeven相关的被包含在系统回顾和荟萃分析。这些试验包括共有980名参与者(GA, N = 487;non-GA, N = 493)。遗传算法提高了血管再通9.0 \ % (GA 84.6 \ %与non-GA 75.6 \ %; OR=1.75, 95\% CI 1.26 to 2.42, P=0.0009) and the proportion of patients with functional recovery improves by 8.4\% (GA 44.6 \% versus non-GA 36.2\%; OR=1.43, 95\% CI 1.04 to 1.98, P=0.03). There was no difference in hemorrhagic complications or 3 month mortality.ConclusionsIn ischemic stroke patients treated with EVT, general anesthesia (GA) is associated with higher recanalization rates and improved functional recovery at 3 months compared with non-GA techniques. Conversion to GA and subsequent intention to treat analysis will underestimate the true therapeutic benefit. GA is established as effective in improving recanalization rates in EVT (7 Class 1 studies) with a high GRADE certainty rating. GA is established as effective in improving functional recovery at 3 months in EVT (5 Class 1 studies) with a moderate GRADE certainty rating. Stroke services need to develop pathways to incorporate GA as the first choice for most endovascular thrombectomy procedures in acute ischemic stroke with a level A recommendation for recanalization and level B recommendation for functional recovery.}, issn = {0028-3878}, URL = {//www.ebmtp.com/content/early/2023/02/16/WNL.0000000000207066}, eprint = {//www.ebmtp.com/content/early/2023/02/16/WNL.0000000000207066.full.pdf}, journal = {Neurology} }