Method Of Anesthesia Research Articles

Investigating the Effect of Educational Film Presentation on the Anxiety Level of Mothers Visiting the Preoperative Anesthesia Clinic

With the increasing number of pediatric surgeries and the transfer of caregiving roles to parents, appropriate preparation and reduction of their stress levels for proper care of children before and after surgery is essential. If parental anxiety can be reduced through various methods, not only can it improve parental performance and their comfort, but it can also prevent the impact of anxiety on the child. Therefore, we aimed to investigate the effect of educational film presentation on the anxiety level of mothers visiting the obstetric anesthesia clinic at the Children's Medical Center in 2020. This study was a randomized double-blind controlled trial conducted as an intervention. Sampling was done randomly, and the study population consisted of two groups of 38 individuals, whose children were candidates for MRI. The intervention group watched the educational film, while the second group served as the control group. Subsequently, their anxiety levels were assessed and compared using the Beck Anxiety Inventory. The data were entered into SPSS Ver. 21 software and analyzed accordingly. The mean age of mothers in this study was 33.41 years with a standard deviation of 7 years. The mean age of children was 3.79 years with a standard deviation of 3.4 years. Among the children, 30 were girls (39.5%) and 46 were boys (60.5%). The mean age of girls was 4.35 years with a standard deviation of 4.16 years, while the mean age of boys was 3.433 years with a standard deviation of 2.787 years. Overall, 39 participants (50.6%) watched the educational film, while 38 participants (49.4%) were in the control group. The mean score of anxiety level according to the Beck Anxiety Inventory (BAI) was 9.47 with a standard deviation of 9.77. The level of anxiety was significantly higher in the intervention group who watched the educational film compared to the control group (P=0.012). The results of the present study indicated that parental anxiety increased after watching the educational video on anesthesia methods. It is recommended that alternative strategies be considered for reducing parental anxiety in future studies.

FEATURES OF ANESTHESIA IN PATIENTS WITH SPECIAL NEEDS. PART 2

Cannabis potentially interacts with drugs commonly used for anesthesia, which can be life-threatening. Dysfunctions of various organs and systems in cannabis users classify them as patients at increased perioperative risk. When planning anesthesia, acute cannabis intoxication and chronic use should be considered, as patients with acute intoxication may require lower doses of anesthetics (but emergence from anesthesia will be significantly prolonged compared to nonintoxicated states). Chronic exposure to cannabinoids outside of acute intoxication leads to downregulation of receptors, which may result in increased anesthesia tolerance when patients abstain from cannabis before anesthesia. Regional anesthesia methods are preferred in cannabis-dependent individuals. Tolerance to propofol is increased in cannabis users. Acute cannabis intoxication mostly causes additive effects with general anesthesia drugs. Chronic cannabis use mostly results in cross-tolerance to general anesthesia drugs. Anesthesiologists, surgeons, and intensive care physicians should understand the impact of cannabis on the action of general anesthesia drugs to implement safe perioperative management.

Efficacy of combined lumbar plexus and parasacral sciatic nerve block in elderly patients undergoing hip fracture surgery: a retrospective analysis

Aims: Hip fractures are a major cause of morbidity and mortality in the elderly population. Anesthesia management significantly affects outcomes in elderly patients. In recent years, peripheral nerve blocks acquired importance, especially in patients where subarachnoid blocks are contraindicated or in patients with severe pulmonary or cardiac diseases. This study aimed to retrospectively evaluate the efficacy of combined lumbar plexus block and parasacral sciatic nerve block in geriatric populations. Methods: Data from patients over 70 years of age (ASA III) who underwent surgery for hip fracture and received combined lumbar plexus and parasacral sciatic nerve blocks between 2014 and 2024 were retrospectively analyzed. The efficacy of anesthesia, the need for intraoperative rescue anesthesia, and hemodynamic parameters were evaluated. Results: The mean age of the 98 patients included in the study was 79.81 ± 8.94 years. Most patients had concomitant chronic diseases. A total of 19 (19.94%) patients were administered Fentanyl 50 mcg and Propofol 0.5 mg/kg for pain at the beginning of surgery, and none of the patients who received sedoanalgesia experienced severe respiratory distress or low oxygen saturation. Anesthesia and analgesia were effectively administered, and the need for intraoperative rescue anesthesia was low. Hemodynamic parameters remained stable. Conclusion: Combined lumbar plexus and parasacral sciatic nerve block is an effective anesthetic method for hip surgery in elderly patients with comorbidities. This method reduces the need for general anesthesia, provides comprehensive analgesia, and maintains hemodynamic stability.

Modern approaches to choosing the method of regional anesthesia during video-assisted thoracoscopic surgery

The objective was to analyze the literature on modern approaches to the choice of regional anesthesia method for thoracoscopic surgical interventions. Materials and methods. A review of the most common approaches to the choice of regional anesthesia method for thoracoscopic surgical interventions was carried out.Results. The analysis of the literature has shown that to date, in the practice of an anesthesiologist and intensivist, there is no single standard for anesthesia of patients during and after thoracoscopic operations, but the use of regional anesthesia methods can increase the positive effects of minimally invasive methods, which include video-assisted thoracoscopic surgeries (VATS). Further studies comparing the efficacy of regional anesthesia methods in thoracic surgery are needed.Conclusion. At the moment, the evidence collected in the world specialized literature confirms that thoracic epidural analgesia (TEA), paravertebral block, erector spinae plane block, and serratus anterior plane block can be considered comparatively effective methods of regional anesthesia in VATS. Meanwhile, high-quality comparative clinical studies that allow us to choose the most effective and safe method of regional anesthesia are limited.

Method of Anesthesia and Perioperative Risk Factors, Maternal Anesthesia Complications, and Neonatal Mortality Following Cesarean Delivery in Africa: A Substudy of a 7-day Prospective Observational Cohort Study

Method of Anesthesia and Perioperative Risk Factors, Maternal Anesthesia Complications, and Neonatal Mortality Following Cesarean Delivery in Africa: A Substudy of a 7-day Prospective Observational Cohort Study

A Comparative Study of Combined Spinal Epidural Anesthesia Versus Spinal Anesthesia in Major Lower Limb Orthopedic Surgeries.

Background Neuraxial blockade includes epidural and spinal anesthesia (SA) that have gained wide acceptance for major lower limb orthopedic surgery. Both techniques are competent in rendering surgical anesthesia and pain relief, with specific advantages and disadvantages. SA has the merits of rapid onset and adequate anesthesia with a small volume of the drug but has significant hypotension and unpredictable duration. Epidural anesthesia allows for finer control over analgesia and the duration of anesthesia but requires more substantial volumes of drugs and is slower in onset. Combined spinal-epidural anesthesia (CSEA) combines the rapid commencement of action of SA with flexibility in epidural anesthesia, thus optimizing the management of the intraoperative and postoperative phases. This study aims to evaluate hemodynamic changes, compare the severity and duration of sensory and motor block, and track any problems related to CSEA and SA in major lower limb orthopedic procedures. Additionally, this study contrasts the hemodynamic, motor, and sensory changes in the two groups. Methodology A total of 30 individuals were randomized to one of two groups in this prospective comparative trial, which included 60 patients receiving major lower limb orthopedic surgery and meeting the American Society of Anesthesiologists physical status I-II criteria. Group A received CSEA, and Group B received SA. The degree and duration of sensory and motor blockade, hemodynamic changes, and complications were all recorded. A p-value of less than 0.05 was used to evaluate statistical significance using Student's t-test and chi-square test. Results The onset of sensory block in our study was earlier in Group B compared to Group A. In both groups, hemodynamic stability was maintained throughout the study. We recorded the onset/duration of sensory and motor block and hemodynamic changes and took mean values to find any significant difference. Postoperative complications and rescue analgesic requirements were monitored and managed and were a part of our study. Conclusions This study compared CSEA and SA regarding the severity and duration of sensory and motor block, hemodynamic stability, and associated complications in major lower limb orthopedic surgeries. The results shed light on the advantages and shortcomings of each anesthesia technique and, therefore, will help choose the correct method of anesthesia in a given surgery.

Liposomal Bupivacaine via an Adductor Canal Block Compared to a Peripheral Nerve Catheter and No Block After Total Knee Arthroplasty: A Retrospective Analysis.

Background As total knee arthroplasty is one of the most common surgeries in the United States, it is important to identify regional anesthesia methods that optimize patient recovery. This study evaluates the effectiveness of adductor canal (AC) blocks with liposomal bupivacaine (LB) compared to other regional anesthesia techniques. We hypothesized that patients receiving single-shot (SS) AC blocks with LB would have lower postoperative opioid consumption compared to other groups. Methods A retrospective cohort analysis was conducted on patients from a single institution between January 2014 and December 2021. The primary outcome assessed was postoperative opioid use, with secondary outcomes including postoperative pain scores and hospital length of stay. Results The final analysis included 280 patients: 41 received an SS AC block with plain local anesthetic, 76 received a peripheral nerve catheter (PNC) with continuous ropivacaine, 79 received an SS AC block with LB, and 84 received no block. In fully adjusted models, postoperative opioid consumption on day one was significantly lower in the SS AC block with LB group compared to the no block group (b = 23.2, SE = 5.7, p < 0.0001), the PNC group (b = 15.5, SE = 5.7, p = 0.01), and the SS AC block with plain local anesthetic group (b = 18.9, SE = 6.9, p = 0.01). Additionally, hospital length of stay was significantly reduced in the LB group compared to the no block group (b = 1.5, SE = 0.3, p < 0.0001), the PNC group (b = 1.1, SE = 0.3, p < 0.0001), and the SS AC block with plain local anesthetic group (b = 1.5, SE = 0.3, p < 0.0001). Conclusions Patients who received an AC block with LB had higher pain scores on postoperative day 0 (POD0) but required less opioid medication on postoperative day 1 (POD1) and had a shorter hospital stay compared to patients who received other types of AC blocks or no block.

Comparison of Infiltration and Inferior Alveolar Nerve Block Injection Techniques in Periodontal Flap Surgery in the Mandible

Abstract Introduction: The efficacy of infiltration versus inferior alveolar nerve block (IANB) injection techniques during periodontal flap surgery in the mandible is crucial for optimising patient care. This comparative study aims to evaluate the pain management, ease of administration and clinical outcomes associated with both anaesthetic methods. Infiltration anaesthesia involves localised administration, targeting specific sites, whereas IANB provides a broader anaesthetic effect by numbing the entire mandibular nerve. Understanding the advantages and limitations of each technique will enhance procedural efficiency and patient comfort. This research contributes valuable insights into best practices for periodontal surgeries. Materials and Methods: Twenty-five subjects who required periodontal flap surgery were included in the study to treat chronic periodontitis in the mandibular jaw. The surgery was performed under local infiltration of an anaesthetic agent on one side of the jaw and by an IANB on the other side. Pain perception was evaluated using the Visual Analogue Scale (VAS) score at various intervals during periodontal flap surgery. The effect of anaesthesia between the two techniques was compared and evaluated by analysis of variance using IBM Corp. IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows [Version 25]. Armonk, New York, USA. IBM Corp; 2017. Results: Analysis determined the onset, duration and termination of anaesthesia induced by infiltration and the IANB technique. The onset and duration of anaesthesia by both techniques were comparable. The pain perception evaluated using the VAS score while using both anaesthesia techniques was also comparable. Conclusion: Infiltration anaesthesia can be used as an alternative to overcome the disadvantages and complications of IANB for periodontal surgery in the mandibular jaw.

Effects of body mass index on mortality in elderly patients with hip fractures.

Hip fractures remain a substantial health concern, particularly among elderly individuals with osteoporosis, leading to high global mortality rates. This study aimed to analyze the association between body mass index (BMI) and postoperative mortality in patients who underwent surgery for hip fractures. A total of 680 patients treated at a single institution between January 2018 and December 2022 were included. Factors such as age, BMI, sex, Charlson Comorbidity Index (CCI), preoperative hemoglobin levels, American Society of Anesthesiologists score, anesthesia method, duration of surgery, and time from injury to surgery were assessed. Underweight status, male sex, higher CCI, and general anesthesia were significantly associated with 1-year and in-hospital mortality. Notably, underweight individuals exhibited a higher risk of mortality than normal-weight individuals, and female patients had lower mortality rates. This study underscores the importance of considering BMI, along with other demographic and clinical factors, in predicting postoperative mortality among patients with hip fractures, aiding the development of tailored management strategies to improve outcomes and reduce complications in this vulnerable patient population.

Intraocular Pressure and Safety of Vitrectomy with Vitreous Gas Replacement using Low-concentration Nitrous Oxide Gas Anesthesia.

This study aims to evaluate the efficacy and safety of vitrectomy with vitreous gas replacement using low-concentration nitrous oxide (N2O) gas anesthesia, focusing on intraocular pressure (IOP) changes, pain, anxiety, and safety outcomes. This retrospective study analyzed 133 patients undergoing fluid-air exchange without use of such as SF6 or C3F8, at Saneikai Tsukazaki Hospital, Japan, from April 2019 to March 2022. Participants were divided into two groups: those receiving low-concentration nitrous oxide gas anesthesia (N2O group) and those receiving local anesthesia with room air inhalation (Air group). IOP, pain, anxiety levels, and intraoperative complications were assessed. No significant differences were found in IOP changes postoperatively between the N2O and Air groups. The N2O group reported significantly lower pain scores and had lower intraoperative systolic blood pressure and heart rate changes compared with the Air group. No significant intraoperative or postoperative complications were observed in either group. Vitrectomy with fluid-air exchange using low-concentration nitrous oxide gas anesthesia is safe, does not increase IOP, and may offer benefits in reducing intraoperative pain and stabilizing vital signs compared with traditional local anesthesia methods. This approach could be considered a viable option for vitreous surgery requiring fluid-air exchange.

Effect of various anesthesia methods on surgical treatment outcomes in patients with proximal femur fracture: a narrative review

Effect of various anesthesia methods on surgical treatment outcomes in patients with proximal femur fracture: a narrative review

Comparison of Intradural Bupivacaine With Epidural Levobupivacaine in Lumbar Endoscopic Spinal Surgery

Objective: In lumbar endoscopic spinal surgery, the choice of a regional anesthetic is important for reducing complications and can affect patient recovery and comfort.Methods: A retrospective analysis was conducted of 66 lumbar microdiscectomies (LMDs) under epidural anesthesia (EA) (n=45) or intradural anesthesia (IA) (n=21) performed by the same surgeon and anesthesiologist. The choice of regional anesthesia in LMD (epidural or intradural) differs between anesthesiologists, and the most frequently anesthetic method used in LMD is general or IA.Results: EA may be more reliable than IA, as it enables the surgeon to perform a neurological exploration by requesting the patient to make leg or foot movements during surgery, but few studies have compared these 2 anesthetic methods in LMD. We found that there was a statistically significant difference (p&lt;0.05) between the 2 groups in the postoperative recovery times and in the use of vasopressors during surgery.Conclusion: We suggest that EA reduces the length of time to ambulate, length of stay in the postanesthesia care unit, and the time until initiation of postoperative rehabilitation. Compared to IA, it offers greater hemodynamic stability and allows neurological exploration during surgery.

Dexmedetomidine administration as a possible cognitive enhancer through increasing the level of brain-derived neurotrophic factors in surgical patients: a systematic review and meta-analysis

ObjectiveThis meta-analysis aimed to investigate the effect of dexmedetomidine on brain-derived neurotrophic factor (BDNF) levels in individuals undergoing various medical procedures. We systematically searched electronic databases and manually identified relevant articles to assess the impact of dexmedetomidine on BDNF levels in surgical patients.MethodsA comprehensive literature search was conducted in PubMed, Scopus, Embase, and Web of Science databases with no language restrictions. Studies that examined the effects of dexmedetomidine administration on BDNF levels in surgical patients were included.ResultsThe overall analysis revealed a statistically significant increase in BDNF levels in individuals receiving dexmedetomidine compared to controls (Standardized Mean Difference SMD = 1.65, 95% CI: 1.02 to 2.28; I2: 89%). Subgroup analyses based on the anesthesia method (p < 0.01), and the type of surgery (p < 0.01) showed significant between-group differences (Fig. 3). The results of the sensitivity analyses indicated that individual studies did not significantly affect the overall results.ConclusionThis meta-analysis indicates that dexmedetomidine administration is associated with a significant increase in BDNF levels in individuals undergoing surgical procedures. These findings highlight the potential role of dexmedetomidine in modulating BDNF levels, which may have implications for optimizing perioperative neuroprotective strategies and improving patient outcomes.

Non-intubated tracheal resection and reconstruction for a tracheal tumor in an 8-year-old child

IntroductionIt has been reported that non-intubated anesthesia can be used successfully in adult trachea reconstruction. Herein, our center reported a case of a child undergoing non-intubated trachea reconstruction for benign tracheal tumors.Case descriptionIn January 2023, it was decided to attempt tracheal resection and reconstruction (TRR) in an 8-year-old child with an inflammatory myofibroblastic tumor under non-intubated spontaneous breathing. After anesthesia induction, the laryngeal mask airway (LMA) was inserted. Thereafter, a bilateral superficial cervical plexus block was performed with 15 mL of 0.25% ropivacaine injected into each side. The patient was induced to resume spontaneous breathing by artificially assisted ventilation with an oxygen flow of 2 to 5 L/min and FiO2=1. After tracheotomy, the oxygen flow was increased to 15 L/min to improve the local oxygen flow to maintain the pulse oxygen saturation (SpO2) above 90% under spontaneous breathing. The patient had stable spontaneous breathing after tracheal anastomosis. The anastomosis was perfect without leakage. The LMA was removed and oxygen was given by the nasal catheter under light sedation at post anesthesia care unit (PACU).ConclusionTracheal reconstruction under spontaneous breathing may be an alternative anesthesia method for upper tracheal surgery in children.

Carotid endarterectomy outcomes according to anesthesia method: General anesthesia or regional anesthesia?

Aim: Surgical strategies in carotid endarterectomy (CEA) vary according to the method of anesthesia, neurological monitoring, shunt use, and closure methods, and the gold standard method has not yet been determined. In this study, we aimed to analyze the superiority and feasibility of CEA under general anesthesia and regional anesthesia. Material and Methods: Demographic characteristics, operative information and follow-up results of 237 patients who underwent CEA between January 2015 and June 2020, 165 patients under regional anesthesia (RA: Group 1) and 72 under general anesthesia (GA: Group 2), were retrospectively analyzed. In Group 1, carotid shunt was placed in patients with a negative awake test (n: 21, 12.7%) and in Group 2 carotid shunt was placed in all cases. Results: There was no statistically significant difference in postoperative stroke, transient ischemic attack (TIA) and cardiovascular mortality (p: 0.48; p: 0.30; p: 0.63, respectively). Although the operation and clamp time were shorter in Group 1, no significant difference was observed (97.93±11.02 min, 101.46±9.49 min p: 0.23; 19.60±5.62 min, 25.62±7.47 min p: 0.24, respectively). The duration of intensive care unit (ICU) stay was shorter and statistically significant in Group 1. (p: 0.003). There was no significant difference for restenosis rates (p: 0.34). Conclusion: There was no significant increase in postoperative complications in the RA group compared to the GA group despite shunting according to the awake test. Also, patients who underwent RA stayed in ICU for a shorter period of time. CEA can be performed under both GA and RA with similar complication rates.

Anesthesia Management in a Low Weight Patient with Parkinson&amp;apos;s Disease: A Case Report

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: Parkinson&amp;apos;s disease (PD) is a progressive neurological disease related to the destruction of dopaminergic neurons in the substantia nigra, basket spot and other brain regions, which is mainly characterized by motor neurological disorders and non-motor neurological disorders. Middle-aged and elderly people are more common, with more women than men. Polypharmacy in PD patients may lead to potential interactions with anesthetic drugs, so perioperative management is very important. &amp;lt;i&amp;gt;Case presentetion&amp;lt;/i&amp;gt;: An 80-year-old female with a medical history of PD weighing 28kg, planed to undergo elective peritoneoscopically assisted transvaginal uterine abdominal wall suspension under general anesthesia. Antiparkinsonian medications continued until just before the induction of anesthesia. Preoperative examinations were completed and they showed no obvious abnormality. Vital signs, train-of-four (TOF) and bispectral index (BIS) were monitored to guide the administration of anesthesia. Appropriate sedatives, analgesics, muscle relaxants and antiemetics were selected after fully assessed the patient&amp;apos;s condition and drug interactions during the perioperative period. The patient successfully completed the surgery and discharged from hospital. &amp;lt;i&amp;gt;Conclusions&amp;lt;/i&amp;gt;: General anesthesia (GA) is the main anesthesia method for patients with Parkinson&amp;apos;s disease undergoing surgery. When patients with PD undergo surgery, the anesthesiologists should fully and carefully evaluate the patient&amp;apos;s status and preoperative combination of medications. Perioperative drugs that aggravate Parkinson&amp;apos;s disease should be avoided in order to facilitate a smooth recovery after surgery.

Anesthesia Type Outcome in Severe Pre-eclampsia with Caesarean Section

Background: Preeclampsia is a hypertensive disorder during pregnancy with fetomaternal mortality. The choice of anesthesia method for cesarean sections among preeclamptic women is still debated. Objective: To compare the outcomes of spinal and general anesthesia in a cesarean section among preeclamptic women. Methods: A prospective study was conducted at Al-Imam Al-Sajjad Hospital/Al-Najaf Health Directorate from February 2021 to September 2023. Women undergoing cesarean sections due to severe preeclampsia were enrolled in the spinal or general anesthesia group. Data on maternal age, gestational age at delivery, parity, Apgar scores, maternal mortality and perinatal mortality were recorded. The background characteristics and outcomes were compared between both groups. We excluded women with mild preeclampsia, multiple pregnancies, other pregnancy medical disorders, gestational age &lt; 32 weeks, cases of eclampsia, and general anesthesia following spinal anesthesia failure. Results: The general anesthesia group had a significantly lower Apgar score at 1 minute than the spinal anesthesia group (27.3% and 57.4%, p=0.006), and at 5 minutes (15.2% and 37.03%, p=0.005). The study groups showed no significant difference regarding maternal and perinatal mortality. Conclusions: Maternal and perinatal mortality were not affected by anesthesia type in severe preeclampsia, but general anesthesia caused a higher proportion of birth asphyxia.

Patient-Experience of Trapeziectomy for Trapeziometacarpal Osteoarthritis in Wide-Awake Local Anesthesia no Tourniquet, 2-Year Follow-up.

The purpose of this study was to assess the patient experience of trapeziectomy under WALANT for trapeziometacarpal joint (TMJ) osteoarthritis (OA) in a prospective study with 2-year follow-up. The study included 23 patients with TMJ OA undergoing trapeziectomy with WALANT. All patients were seen by a hand therapist preoperatively and at 3, 12, and 24 months postoperatively. At each visit, VAS pain scores, thumb range of motion, grip strength, and Disabilities of the Arm, Shoulder and Hand (DASH) score were assessed. The Picker Patient Experience (PPE-15) questionnaire was administered within 2 weeks of surgery. All 23 patients completed the PPE-15 questionnaire. Their mean age was 64 years. The 21 patients who remained at the 24-month follow-up all said they would choose the same anaesthesia method again. At this follow-up, VAS pain scores, thumb range of motion, key pinch grip and DASH scores had improved significantly, while thumb opposition and hand grip strength remained largely unchanged. The majority of patients felt well informed before and during the procedure, and all patients rated pain relief as good or satisfactory. Nearly 40% of patients reported receiving inadequate information about the postoperative medications. Patients have a positive attitude to trapeziectomy with WALANT, and seem to prefer WALANT over other methods of anaesthesia. Trapeziectomy with WALANT for TMJ OA is a safe procedure and appears to give a functional outcome similar to trapeziectomy under general anaesthesia. Trapeziectomy with WALANT for TMJ OA is safe, preferred by patients and has similar clinical outcome as trapeziectomy in general anesthesia. trapeziectomy, osteoarthritis, WALANT.

Comparison of safety of general anesthesia and intravenous sedation during third-molar extraction surgery

This study compared the safety of general anesthesia (GA) and intravenous sedation (IVS) in patients who underwent extraction of one or more third molars. Data from 1260 patients (GA group, n = 1043; IVS group, n = 217) were retrospectively analyzed, including demographics, preoperative data, intraoperative hemodynamic parameters (blood pressure, heart rate, and oxygen saturation level), and medications administered intraoperatively and postoperatively. The incidence of intraoperative circulatory variations, surgery and anesthesia durations, postoperative complications, and medication use were assessed and compared. The GA group had longer anesthesia and surgery durations, a higher incidence of hypotension, and a higher frequency of postoperative analgesic use than the IVS group. Dexmedetomidine was the most frequently used sedative agent. The IVS group had a lower incidence of intraoperative hypotension but they had a higher need for vasopressors in the recovery room. Both anesthesia methods maintained satisfactory oxygen saturation levels and sufficient anesthesia throughout the procedure, but they showed different characteristics regarding the duration of surgery and anesthesia duration, hemodynamic stability, and postoperative analgesic needs. IVS may be preferable for patients at risk of cardiovascular complications such as hypotension or tachycardia during surgery.

Comparison of anesthesia methods for intra-arterial therapy of patients with acute ischemic stroke: an updated meta-analysis and systematic review

ObjectivesCurrently, there remains debate regarding the optimal anesthesia approach for patients undergoing intra-arterial therapy for acute ischemic stroke. Therefore, we conducted a comparative analysis to assess the effects of general anesthesia versus non general anesthesia on patient outcomes.MethodsThe research methodology entailed comprehensive searches of prominent databases such as the Cochrane Library, PubMed, Scopus, and Web of Science, covering the period from January 1, 2010, to March 1, 2024. Data synthesis employed techniques like risk ratio or standardized mean difference, along with 95% confidence intervals. The study protocol was prospectively registered with PROSPERO (CRD42024523079).ResultsA total of 27 trials and 12,875 patients were included in this study. The findings indicated that opting for non-general anesthesia significantly decreased the risk of in-hospital mortality (RR, 1.98; 95% CI: 1.50 to 2.61; p<0.00001; I2 = 20%), as well as mortality within three months post-procedure (RR, 1.24; 95% CI: 1.15 to 1.34; p<0.00001; I2 = 26%), while also leading to a shorter hospitalization duration (SMD, 0.24; 95% CI: 0.15 to 0.33; p<0.00001; I2 = 44%).ConclusionIschemic stroke patients who undergo intra-arterial treatment without general anesthesia have a lower risk of postoperative adverse events and less short-term neurological damage. In routine and non-emergency situations, non-general anesthetic options may be more suitable for intra-arterial treatment, offering greater benefits to patients. In addition to this, the neuroprotective effects of anesthetic drugs should be considered more preoperatively and postoperatively.