% 0期刊文章%坎贝尔,道格拉斯%巴特勒,爱丽丝%坎贝尔,Ruby布莱斯% Ho Jess %理发师,p . Alan % T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% D R 10.1212 / WNL 2023%。0000000000207066 % J半岛投注体育官网神经病学% P 10.1212 / WNL。0000000000207066 X %的背景和objectivesEndovascular血栓切除术(EVT)大血管闭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% non-GA 75.6%;或= 1.75,95%可信区间1.26到2.42,P = 0.0009),功能恢复患者的比例提高了8.4% (GA 44.6% 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. %U //www.ebmtp.com/content/neurology/early/2023/02/16/WNL.0000000000207066.full.pdf