Rigorous anaesthesia management protocol for patients with intracranial arterial stenosis: a prospective controlled-cohort study

BMJ Open
Azim N LaiwallaNestor R Gonzalez

Abstract

Reducing variability is integral in quality management. As part of the ongoing Encephaloduroarteriosynangiosis Revascularisation for Symptomatic Intracranial Arterial Stenosis (ERSIAS) trial, we developed a strict anaesthesia protocol to minimise fluctuations in patient parameters affecting cerebral perfusion. We hypothesise that this protocol reduces the intraoperative variability of targeted monitored parameters compared to standard management. Prospective cohort study of patients undergoing encephaloduroarteriosynangiosis surgery versus standard neurovascular interventions. Patients with ERSIAS had strict perioperative management that included normocapnia and intentional hypertension. Control patients received regular anaesthetic standard of care. Minute-by-minute intraoperative vitals were electronically collected. Heterogeneity of variance tests were used to compare variance across groups. Mixed-model regression analysis was performed to establish the effects of treatment group on the monitored parameters. Tertiary care centre. 24 participants: 12 cases (53.8 years ± 16.7 years; 10 females) and 12 controls (51.3 years ± 15.2 years; 10 females). Adults aged 30-80 years, with transient ischaemic attack or non-disabling strok...Continue Reading

Associated Clinical Trials

Mar 27, 2013·Nestor R. Gonzalez, MD, MSCR.Nestor R. Gonzalez, MD, MSCR.

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Citations

Aug 31, 2017·International Journal of Vascular Medicine·Wouter W Jansen KlompArno P Nierich

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Methods Mentioned

BETA
percutaneous transluminal angioplasty

Clinical Trials Mentioned

NCT01819597

Software Mentioned

JMP
ERSIAS
GESICA
SAMMPRIS

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