Why carry out this study?

The method of anesthesia may be a potential factor affecting the patient's prognosis. General anesthesia (GA), conscious sedation (CS), and local anesthesia (LA) are three alternative anesthetic methods, and there is no definitive conclusion as to which is optimal.

GA is not the anesthetic method of choice for operators in the real world because it is time-consuming. The simplicity and ease of operation of LA, the basic anesthetic method used for mechanical thrombectomy (MT), is faced with patient agitation intraoperatively. Notably, CS has a short operation time, practicality, and good sedation, which may be a good measure to control agitation during MT.

Unfortunately, there are few studies of MT anesthetic methods involving rescue CS during operation. The results of this study are based on a single-center experience developing a retrospective study of two anesthetic modalities, intraoperative rescue CS versus LA, to explore the impact of rescue CS on the clinical outcome of patients with anterior circulation acute ischemic stroke (AIS).

The hypothesis was that the rescue CS had an effect on clinical outcomes of patients who receive MT.

What was learned from the study?

Rescue CS was associated with the clinical outcomes of patients with anterior circulation AIS receiving MT.The rescue CS has a significantly increased risk of poststroke pneumonia (PSP), particularly in patients with dysphagia.

The implication of this study is that the rescue CS should be avoided if possible in patients with anterior circulation acute ischemic stroke with higher National Institutes of Health Stroke Scale (NIHSS) scores and dysphagia.