Summary of findings 2. General anaesthesia compared to non‐general anaesthesia for acute ischaemic stroke endovascular treatment (long‐term).
| General anaesthesia compared to non‐general anaesthesia for acute ischaemic stroke endovascular treatment (long‐term) | ||||||
| Patient or population: acute ischaemic stroke endovascular treatment (long‐term) Setting: – Intervention: general anaesthesia Comparison: non‐general anaesthesia | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with non‐general anaesthesia | Risk with general anaesthesia | |||||
| Functional outcome (dichotomous; mRS ≤ 2) | Study population | RR 1.21 (0.93 to 1.58) | 625 (4 RCTs) | ⊕⊕⊝⊝ Lowa,b | — | |
| 330 per 1000 | 400 per 1000 (307 to 522) | |||||
| Functional outcome (continuous; mRS ≤ 2) | The mean functional outcome (continuous; mRS ≤ 2) was 0 | MD 0.14 lower (0.34 lower to 0.06 higher) | — | 978 (7 RCTs) | ⊕⊕⊝⊝ Lowb,c | — |
| Neurological impairment (NIHSS) | — | — | — | — | — | Not reported |
| Stroke‐related mortality | Study population | RR 0.88 (0.64 to 1.22) | 843 (6 RCTs) | ⊕⊕⊝⊝ Lowb,c | — | |
| 191 per 1000 | 169 per 1000 (123 to 234) | |||||
| All intracranial haemorrhage | — | — | — | — | — | Not reported |
| Target artery revascularisation status | — | — | — | — | — | Not reported |
| Time to revascularisation | — | — | — | — | — | Not reported |
| Adverse events | — | — | — | — | — | Not reported |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; mRS: modified Rankin Scale; mTICI: modified Thrombolysis in Cerebral Infarction; NIHSS: National Institutes of Health Stroke Scale; RCT: randomised controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded one level due to high risk of performance and attrition bias. bDowngraded one level due to imprecision: 95% CI consistent with possible benefit and harm. cDowngraded one level due to high risk of performance, attrition, reporting and other bias.