Association of Conscious Sedation With Dexmedetomidine and Outcome in Stroke Patients Undergoing Thrombectomy in the DEVT and RESCUE-BT Trials

作者：Gong Chen, Jiacheng Huang, Zhongming Qiu, Meng Guo, Liyuan Chen, Hongfei Sang, Weilin Kong, Liping Huang, Pan Hu, Yangmei Chen, Fengli Li, Thanh N. Nguyen, Chang Liu · 发表于：Neurology · 年份：2024 · DOI：10.1212/wnl.0000000000209953 · 被引用次数：9 · 研究领域：Anesthesia and Sedative Agents、Acute Ischemic Stroke Management、Intensive Care Unit Cognitive Disorders

BACKGROUND AND OBJECTIVES: Although dexmedetomidine (DEX) is widely administered during endovascular treatment (EVT) to enhance procedural adherence of patients with acute ischemic stroke (AIS) with large vessel occlusion, there is limited research on the association of DEX and outcomes among these patients. Hence, this study aimed to explore the safety and outcomes of DEX during conscious sedation (CS) in a real-world setting among patients undergoing EVT. METHODS: This study was an individual patient-level pooled analysis of 2 multicenter randomized clinical trials RESCUE-BT and DEVT. This study included patients who underwent EVT because of occlusion of the internal carotid artery or middle cerebral artery. The DEX group included those receiving intraprocedural DEX for CS, whereas the patients without intraprocedural DEX sedation were categorized into the non-DEX group. The primary outcome was functional independence (modified Rankin Scale score of 0-2 at 90 days). Adjusted odds ratio (aOR) and 95% CI were obtained by logistic regression models. RESULTS: < 0.001). In subgroup analysis, similar results were found in intraprocedural DEX-treated patients when compared with local anesthesia or intraprocedural midazolam-treated patients, respectively. DISCUSSION: There was a negative association between procedural DEX administration during CS and functional outcomes in patients with AIS receiving EVT in a real-world setting. A larger cohort is warranted to validate our findings...