National survey on perioperative anaesthetic management in the endovascular treatment of acute ischaemic stroke

• Published in: Revista española de anestesiología y reanimación Vol. 65; no. 1; pp. 13 - 23
• Main Authors: Romero Kräuchi, O, Valencia, L, Iturri, F, Mariscal Ortega, A, López Gómez, A, Valero, R
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01.01.2018
• Subjects: Anesthesia - standards; Anesthesiology; Brain Ischemia - surgery; Endovascular Procedures; Health Care Surveys; Humans; Perioperative Care - standards; Practice Patterns, Physicians; Spain; Stroke - surgery; Spain; Tratamiento endovascular; Encuesta descriptiva; Endovascular treatment; Descriptive questionnaire; Neuro-anaesthesia; Neuroanestesia; Accidente cerebrovascular isquémico; Ischaemic stroke
• ISSN: 2340-3284; 2341-1929
• DOI: 10.1016/j.redar.2017.07.005

To assess the anaesthetic management of treatment for endovascular acute ischaemic stroke (AIS) in Spain. A survey was designed by the SEDAR Neuroscience Section and sent to the Spanish anaesthesiology departments with a primary stroke centre between July and November 2016. Of the 47 hospitals where endovascular treatment of AIS is performed, 37 anaesthesiology departments participated. Thirty responses were obtained; three of which were eliminated due to duplication (response rate of 72.9%). Health coverage for AIS endovascular treatment was available 24hours a day in 63% of the hospitals. The anaesthesiologist in charge of the procedure was physically present in the hospital in 55.3%. There was large inter-hospital variability in non-standard monitoring and type of anaesthesia. The most important criterion for selecting type of anaesthesia was multidisciplinary choice made by the anaesthesiologist, neurologist and neuroradiologist (59.3%). The duration of time from arrival to arterial puncture was 10-15minutes in 59.2%. In 44.4%, systolic blood pressure was maintained between 140-180mmHg, and diastolic blood pressure<105mmHg. Glycaemic levels were taken in 81.5% of hospitals. Intravenous heparinisation was performed during the procedure in 66.7% with different patterns of action. In cases of moderate neurological deterioration with no added complications, 85.2% of the included hospitals awakened and extubated the patients. The wide variability observed in the anaesthetic management and the organization of the endovascular treatment of AIS demonstrates the need to create common guidelines for anaesthesiologists in Spain.