Choice of Anesthesia for Endovascular Treatment of Acute Ischemic Stroke in Posterior Circulation

Not Applicable

Completed

• Conditions: Posterior Circulation Brain Infarction
• Interventions: Procedure: General anesthesia; Procedure: Local anesthesia/concious sedation; Procedure: Spontaneous breath; Procedure: Controlled ventilation

• Registration Number: NCT03317535
• Lead Sponsor: Beijing Tiantan Hospital

Brief Summary

There is few randomized controlled clinical to investigated the impact of anesthetic type on outcome in patients with acute ischemic stroke in posterior cerebral circulation. It is unknown whether the choice of anesthesia is impacted on the outcomes for these patients or not. The investigators will perform a randomized controlled pilot clinical trial of general anesthesia versus local anesthesia/conscious sedation to explore and find out a potential fact whether anesthetic type alters perioperative neurological function in patients with acute ischemic stroke in posterior cerebral circulation.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2017-10-15
• Study First Submitted QC: 2017-10-20
• Study First Posted: 2017-10-23
• Study Start: 2018-03-18
• Primary Completion: 2021-06-23
• Study Completion: 2021-06-23
• Status Verified: 2023-05
• Last Update Submitted: 2023-05-17
• Last Update Posted: 2023-05-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 93

Inclusion Criteria

• Patients with acute ischemic stroke in posterior cerebral circulation scheduled to receive emergency endovascular treatment; Age > 18; The onset time is within 24 hours; Modified rankin score ≤2 before onset.

Exclusion Criteria

• Radiological ambiguity concerning infarction and vessel occlusion; Additional intracerebral hemorrhage; Anterior circulation infraction; Coma on admission (Glasgow coma score less than 8); NIHSS less than 6 or more than 30; Severe agitation or seizures on admission; Obvious loss of airway protective reflexes and/or vomiting on admission; Being intubated before treatment on admission; Known allergy to anesthetic or analgesic;

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Local anesthesia/conscious sedation	Spontaneous breath	Patients will be injected by propofol (adjusted by bispectral index scale ≥70 ) and /or remifentanil（0.01-0.06μg/kg/min）. Patients will maintain spontaneous breathing.
General anesthesia	Controlled ventilation	Patients will be induced with remifentanil (0.2-0.8 μg/kg), propofol (1-2mg/kg) and rocuronium (0.6 mg/kg). Anesthesia will then be maintained keep the BIS between 40 and 60 with propofol and remifentanil. After tracheal intubation, patients will be kept with controlled ventilation.
General anesthesia	General anesthesia	Patients will be induced with remifentanil (0.2-0.8 μg/kg), propofol (1-2mg/kg) and rocuronium (0.6 mg/kg). Anesthesia will then be maintained keep the BIS between 40 and 60 with propofol and remifentanil. After tracheal intubation, patients will be kept with controlled ventilation.
Local anesthesia/conscious sedation	Local anesthesia/concious sedation	Patients will be injected by propofol (adjusted by bispectral index scale ≥70 ) and /or remifentanil（0.01-0.06μg/kg/min）. Patients will maintain spontaneous breathing.

Primary Outcome Measures

Name	Time	Method
modified rankin score（mRS）	post-procedural 90 days	Modified rankin score（mRS）is used to evaluate the primary outcome. The scale of mRS is 0 to 6. The best neurological outcome is the mRS with 0, indicating no any symptom left, and a good neurological outcome is agreed with a mRS≤2. mRS of 6 is the worst, indicating death. mRS will be evaluated by outcomes assessor who is blinded to the grouping.

Trial Locations

Locations (2)

Ruquan Han; 🇨🇳 Fengtai, Beijing, China

Fan Wang; 🇨🇳 Guiyang, Guizhou, China