不同麻醉方式对急性基底动脉闭塞血管内治疗患者早期神经功能预后的影响OA

Objective To investigate the effects of general anesthesia and conscious sedation anesthesia on the early neurologi-cal prognosis of patients with acute basilar artery occlusion(BAO)treated by endovascular therapy.Methods The clinical data of 178 patients with acute BAO who received endovascular therapy in Beijing Tiantan Hospital from May 2018 to April 2024 were retrospective-ly analyzed.The patients were divided into a general anesthesia group(n=139)and a conscious sedation anesthesia group(n=39).National Institutes of Health Stroke Scale(NIHSS)scores of the two groups were recorded before and 24 hours after surgery.Univariate analysis was performed to screen variables,followed by multivariable logistic regression to explore the effects of different anesthesia methods on the early neurological function of the patients.Results There was no statistically significant difference between the two groups in age,gender,cerebrovascular high-risk factors,onset mode,preoperative laboratory tests,occlusion site,and stroke type.Compared with the conscious sedation anesthesia group,the preoperative NIHSS score of the general anesthesia group[22(11,35)vs.16(6,30)]and the postoperative 24-hour NIHSS score[17(16,20)vs.9(8,14)]were higher,the intraoperative stent thrombecto-my rate,the intra-arterial tirofiban use rate and intraoperative angioplasty operation rate were higher,and the duration of anesthesia was longer,and all differences were statistically significant(P<0.05).Multivariate analysis showed that there was a statistically significant difference in early neurological improvement between the two groups(OR=0.31;95%CI:0.11-0.84;P=0.02).Conclusions An-esthesia method is an independent factor influencing the early neurological prognosis of patients with acute BAO treated by endovascular therapy,and general anesthesia is associated with poorer early neurological prognosis.