A study in JAMA Neurology examined monitored anesthesia care's efficacy and effectiveness, Neurology Advisor reports.
University of Pittsburgh Medical Center's Ashutosh P. Jadhav, MD, and colleagues conducted a retrospective, matched case-control study of 215 patients with posterior circulation strokes. Researchers excluded 39 patients because of emergent intubation. Researchers investigated both clinical and angiographic outcomes in patients with vertebrobasilar occlusion strokes who received monitored anesthesia care.
Approximately 35.8 percent of patients received monitored anesthesia care and 64.2 percent received general anesthesia. Conversion from monitored anesthesia care to general anesthesia occurred in 13 percent of cases.
Here's what they found.
1. There was no significant difference in the 90-day modified Rankin Scale score for the MAC group or for the observed comparable group within the elective general anesthesia group.
2. Researchers found no differences in reperfusion success rate, parenchymal hematomas, wire perforation, good outcome or 90-day mortality rate.
3. Neither group had good outcomes after multivariate conditional logistic regression.
Researchers said the study's retrospective design and small sample size were significant limitations.
Researchers concluded, "We report what is, to our knowledge, the largest series of patients undergoing endovascular therapy for posterior circulation with monitored anesthesia care and demonstrate that monitored anesthesia care is feasible and appears to be as safe and effective as general anesthesia."