Anesthetic management of patients with acute stroke.
Stroke is a major cause of death and disability. Anesthesiologists are likely to encounter patients with stroke and must be aware of the anesthetic considerations for these patients. Intravenous thrombolysis and intra-arterial thrombolysis are effective treatments for acuteischemic stroke as well as evolving endovascular techniques such as mechanical clot retrieval. Recent retrospective studies have found an association between general anesthesia and poor clinical outcome. The results of these studies have several limitations, and current evidence is inadequate to guide the choice of anesthesia in patients with acute stroke. The choice of anesthesia must be based on individual patient factors until further research is completed.
Department of Anesthesiology, Pharmacology and Therapeutics, Vancouver General Hospital, University of British Columbia,910 West 10th Avenue, Vancouver, British Columbia, Canada. alana.flexman@vch.ca
Alana M
AM
Flexman
Anne L
AL
Donovan
Adrian W
AW
Gelb
D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods; D000772:Anesthesia, Local / Q000379:methods; D000777:Anesthetics / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications / Q000628:therapy; D002543:Cerebral Hemorrhage / Q000150:complications / Q000628:therapy; D019299:Decompression, Surgical; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D018696:Neuroprotective Agents / Q000627:therapeutic use; D010808:Physical Examination; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D015912:Thrombolytic Therapy
D000777:Anesthetics; D018696:Neuroprotective Agents