Important Factors Affecting The Selection Of Anesthesia Method During Endovascular Treatment In Patients With AIS

PurposeTo collect the preoperative data of patients with acute ischemic stroke(AIS)requiring endovascular treatment,and to explore the important factors affecting the selection of anesthesia methods during the endovascular treatment of AIS patients,so as to provide reference for the selection of anesthesia methods before endovascular treatment of AIS patients.Objects and MethodsPatients with AIS hospitalized in the Department of Neurosurgery,the Third Affiliated Hospital of Southern Medical University from January 1,2017 to December 31,2021 were selected.According to the inclusion criteria and exclusion criteria,133 AIS patients who underwent endovascular treatment were selected as the research objects.Patients were divided into two groups:general anesthesia(GA)group:patients received general anesthesia with tracheal intubation;Local anesthesia(LA):Patients who received local anesthesia with 2%lidocaine.General information(such as gender,age,past history,etc.),National Institutes of Health Stroke Scale(NIHSS)score and Glasgow coma Scale(GCS)at admission,Location of intracranial embolism(anterior circulation,posterior circulation),Time of embolization(from the onset of symptoms to the start of surgery),and the consciousness at admission were analyzed between the general anesthesia group and the local anesthesia group Finally,influencing factors with statistical differences(P<0.05)were included in binary Logistic regression analysis to screen out the independent influencing factors affecting the selection of anesthesia methods.Result(1)There was no significant difference in age,gender and past history(such as hypertension,diabetes,coronary heart disease,cerebral infarction,etc.)between the two groups(P>0.05).(2)There were significant differences between the two groups in the NIHSS score on admission,the location and time of intracranial embolism(P<0.05),but there were no significant differences in the GCS score on admission,the state of consciousness and the level of the surgeon(P>0.05).(3)The indicators with statistical differences in results(2),such as NIHSS score at admission,intracranial embolism site and embolization time,were included in binary Logistic regression analysis.The final results showed that only the intracranial embolism site and embolization time had statistical differences among the three indicators(P<0.05).ROC curve was used to further analyze the predictive value of embolization time for the choice of anesthesia method,and the results showed that the area under the curve was 0.733(P<0.05).The optimal cut-off value was 6.5h,with a sensitivity of 65.9%and a specificity of 70.8%.ConclusionFor AIS patients undergoing endovascular treatment,Location and duration of intracranial embolization are independent influencing factors for the choice of anesthesia method.Patients with anterior circulation embolization are more likely to choose local anesthesia,and patients with posterior circulation embolization are more likely to choose general anesthesia.Within the therapeutic window,patients with embolization time over 6.5h are more likely to choose general anesthesia.