Anjiyografik Trombektomi Yapılan Hastalarda Kullanılan Anestezi Yönteminin Hemodinamik Stabilite ve Postoperatif Sağ Kalıma Etkisinin Araştırılması

Abstract

Abstract

UMUDOVA S. The Effect Of Anesthetic Method On Hemodynamic Stability And Postoperative Survival In Angiografic Thrombectomy Patients.

Endovascular thrombectomy is the gold standart therapy for acute ischemic stroke treatment. Endovascular thrombectomy can be used under either general anesthesia or conscious sedation. Despite succesful recanalisation, clinical improvement might not always be seen at the end of the procedure.

The aim of this study is to evaluate the effect of the anesthetic method on patients’ morbidity and mortality retrospectively. After obtaining Institutional Ethical Board approval, we searched for the medical records of acute iscemic stroke patients who underwent endovascular thrombectomy therapy by interventional radiology department between january 2015-december 2019. We enrolled 102 of 203 patients in our study due to the missing records. Anesthetic induction technique, demographic variables, hemodynamic variables, EtCO2, blood glucose levels and body temperature were recorded. There were no significant difference between patients in terms of demografic variables, ASA scoring and concommittant diseases. According to our results, the most decisive factors for 90 day survival were blood glucose level and total anestesia time during procedure. When evaluated independent from other factors, blood glucose levels above 140 mg/Dl can increase mortality rates 4,712 times. Every 60 minute additional anestesia time, independent from other factors will increase mortality risk 1.996 times. According to the parameters which we obtained from our study, we conclude that tight glucose control should be applied perioperatively to reduce the mortality rates. Also in order to decrease anesthesia it is crucial to complete necessary preparations before anesthesia induction and inform the team when procedure is prolonged and follow up those patients closely in intensive care units. KEY WORDS: acute iscemic stroke, endovascular thrombectomy, neuroradiology, anesthesia time, 90 day survival