Evidence map›Paper›PMID 37268801›Full record

SynthesisCanadian journal of anaesthesia = Journal canadien d'anesthesie2023

General anesthesia or conscious sedation for thrombectomy in stroke patients: an updated systematic review and meta-analysis.

Federico Geraldini, Paolo Diana, Davide Fregolent, Alessandro De Cassai, Annalisa Boscolo, Tommaso Pettenuzzo, Nicolò Sella, Irene Lupelli, Paolo Navalesi, Marina Munari

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Federico GeraldiniUOC Anesthesia and Intensive Care Unit, Institute of Anesthesia and Intensive Care, Padua University Hospital, Via Giustiniani 1, 35127, Padua, Italy.
Paolo DianaUOC Anesthesia and Intensive Care Unit, Institute of Anesthesia and Intensive Care, Padua University Hospital, Via Giustiniani 1, 35127, Padua, Italy.
Davide FregolentDepartment of Medicine, University of Padua, Padua, Italy.
Alessandro De CassaiUOC Anesthesia and Intensive Care Unit, Institute of Anesthesia and Intensive Care, Padua University Hospital, Via Giustiniani 1, 35127, Padua, Italy.ORCID http://orcid.org/0000-0002-9773-1832
Annalisa BoscoloUOC Anesthesia and Intensive Care Unit, Institute of Anesthesia and Intensive Care, Padua University Hospital, Via Giustiniani 1, 35127, Padua, Italy.
Tommaso PettenuzzoUOC Anesthesia and Intensive Care Unit, Institute of Anesthesia and Intensive Care, Padua University Hospital, Via Giustiniani 1, 35127, Padua, Italy.
Nicolò SellaUOC Anesthesia and Intensive Care Unit, Institute of Anesthesia and Intensive Care, Padua University Hospital, Via Giustiniani 1, 35127, Padua, Italy.
Irene LupelliDepartment of Medicine, University of Padua, Padua, Italy.
Paolo NavalesiUOC Anesthesia and Intensive Care Unit, Institute of Anesthesia and Intensive Care, Padua University Hospital, Via Giustiniani 1, 35127, Padua, Italy.
Marina MunariUOC Anesthesia and Intensive Care Unit, Institute of Anesthesia and Intensive Care, Padua University Hospital, Via Giustiniani 1, 35127, Padua, Italy.
University of Padua · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEndovascular treatment for stroke patients usually requires anesthesia care, with no current consensus on the best anesthetic management strategy. Several randomized controlled trials and meta-analyses have attempted to address this. In 2022, additional evidence from three new trials was published: the GASS trial, the CANVAS II trial, and preliminary results from the AMETIS trial, prompting the execution of this updated systematic review and meta-analysis. The primary objective of this study was to evaluate the effects of general anesthesia and conscious sedation on functional outcomes measured with the modified Rankin scale (mRS) at three months.

methodsWe performed a systematic review and meta-analysis of randomized controlled trials investigating conscious sedation and general anesthesia in endovascular treatment. The following databases were examined: PubMed, Scopus, Embase, and the Cochrane Database of Randomized Controlled Trials and Systematic Reviews. The Risk of Bias 2 tool was used to assess bias. In addition, trial sequence analysis was performed on the primary outcome to estimate if the cumulative effect is significant enough to be unaffected by further studies.

resultsNine randomized controlled trials were identified, including 1,342 patients undergoing endovascular treatment for stroke. No significant differences were detected between general anesthesia and conscious sedation with regards to mRS, functional independence (mRS, 0-2), procedure duration, onset to reperfusion, mortality, hospital length of stay, and intensive care unit length of stay. Patients treated under general anesthesia may have more frequent successful reperfusion, though the time from groin to reperfusion was slightly longer. Trial sequential analysis showed that additional trials are unlikely to show marked differences in mean mRS at three months.

conclusionsIn this updated systematic review and meta-analysis, the choice of anesthetic strategy for endovascular treatment of stroke patients did not significantly impact functional outcome as measured with the mRS at three months. Patients managed with general anesthesia may have more frequent successful reperfusion.

trial registrationPROSPERO (CRD42022319368); registered 19 April 2022.

Indexed as

Anesthesia, GeneralProcedural SedationStrokeThrombectomyHumansanesthesiameta-analysisstroke

Identifiers

PMID37268801
OpenAlexW4379162761

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.