Comparison 1. General anaesthesia versus non‐general anaesthesia (early time point).

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1.1 Functional outcome (continuous; mRS)	1	90	Mean Difference (IV, Fixed, 95% CI)	0.00 [‐0.31, 0.31]
1.2 Neurological impairment	7	982	Mean Difference (IV, Random, 95% CI)	‐0.29 [‐1.18, 0.59]
1.2.1 NIHSS (24–48 hours)	4	370	Mean Difference (IV, Random, 95% CI)	‐0.09 [‐1.20, 1.02]
1.2.2 NIHSS at 24 hours	3	612	Mean Difference (IV, Random, 95% CI)	‐0.79 [‐2.48, 0.89]
1.3 Neurological impairment (only low‐risk trials)	2	278	Mean Difference (IV, Random, 95% CI)	‐1.19 [‐3.84, 1.46]
1.4 Stroke‐related mortality	3	330	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.52, 1.84]
1.5 All intracranial haemorrhage	5	693	Risk Ratio (M‐H, Random, 95% CI)	0.92 [0.65, 1.29]
1.6 Target artery revascularisation (dichotomous; mTICI 2b‐3)	7	982	Risk Ratio (M‐H, Random, 95% CI)	1.10 [1.02, 1.18]
1.7 Time to revascularisation from groin puncture until arterial reperfusion (minutes)	5	498	Mean Difference (IV, Random, 95% CI)	2.91 [‐5.11, 10.92]
1.8 Adverse events (substantial movement)	3	280	Risk Ratio (M‐H, Random, 95% CI)	0.06 [0.01, 0.30]
1.9 Adverse events (vomiting)	2	168	Risk Ratio (M‐H, Random, 95% CI)	0.32 [0.01, 7.79]
1.10 Adverse events (aspiration)	3	368	Risk Ratio (M‐H, Random, 95% CI)	0.43 [0.06, 2.86]
1.11 Adverse events (loss of airway)	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	0.20 [0.01, 4.05]
1.12 Adverse events (haemodynamic instability)	2	229	Risk Ratio (M‐H, Fixed, 95% CI)	0.21 [0.05, 0.79]
1.13 Adverse events (delayed extubation)	2	240	Risk Ratio (M‐H, Random, 95% CI)	3.05 [0.42, 22.29]
1.14 Adverse events (hypoxaemia)	2	190	Risk Ratio (M‐H, Random, 95% CI)	1.05 [0.22, 5.06]
1.15 Adverse events (target vessel injury: perforation, dissection, or several vasospasm)	4	408	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.18, 3.90]
1.16 Adverse events (artery perforation)	5	752	Risk Ratio (M‐H, Random, 95% CI)	0.82 [0.37, 1.83]
1.17 Adverse events (clot migration to previously unaffected territory)	3	562	Risk Ratio (M‐H, Random, 95% CI)	1.74 [0.75, 4.01]
1.18 Adverse events (pneumonia)	5	509	Risk Ratio (M‐H, Random, 95% CI)	1.85 [0.93, 3.66]
1.19 Adverse events (perforation, dissection, distal thrombus migration)	2	434	Risk Ratio (M‐H, Fixed, 95% CI)	0.82 [0.45, 1.49]