Choice of Anesthesia for Endovascular Treatment of Acute Ischemic Stroke in Posterior Circulation (CANVAS-II)

Capital Medical University

Status: Completed

Conditions: Posterior Circulation Brain Infarction

Treatments: Procedure: General anesthesia; Procedure: Spontaneous breath; Procedure: Local anesthesia/concious sedation; Procedure: Controlled ventilation

Study type: Interventional

Funder types: Other

Identifiers

NCT03317535

2017-10-15

Details and patient eligibility

About

There is few randomized controlled clinical to investigated the impact of anesthetic type on outcome in patients with acute ischemic stroke in posterior cerebral circulation. It is unknown whether the choice of anesthesia is impacted on the outcomes for these patients or not. The investigators will perform a randomized controlled pilot clinical trial of general anesthesia versus local anesthesia/conscious sedation to explore and find out a potential fact whether anesthetic type alters perioperative neurological function in patients with acute ischemic stroke in posterior cerebral circulation.

Enrollment: 93 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with acute ischemic stroke in posterior cerebral circulation scheduled to receive emergency endovascular treatment; Age > 18; The onset time is within 24 hours; Modified rankin score ≤2 before onset.

Exclusion criteria

• Radiological ambiguity concerning infarction and vessel occlusion; Additional intracerebral hemorrhage; Anterior circulation infraction; Coma on admission (Glasgow coma score less than 8); NIHSS less than 6 or more than 30; Severe agitation or seizures on admission; Obvious loss of airway protective reflexes and/or vomiting on admission; Being intubated before treatment on admission; Known allergy to anesthetic or analgesic;

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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93 participants in 2 patient groups

Local anesthesia/conscious sedation

Other group

Description:

Patients will be injected by propofol (adjusted by bispectral index scale ≥70 ) and /or remifentanil（0.01-0.06μg/kg/min）. Patients will maintain spontaneous breathing.

Treatment:

Procedure: Local anesthesia/concious sedation

Procedure: Spontaneous breath

General anesthesia

Other group

Description:

Patients will be induced with remifentanil (0.2-0.8 μg/kg), propofol (1-2mg/kg) and rocuronium (0.6 mg/kg). Anesthesia will then be maintained keep the BIS between 40 and 60 with propofol and remifentanil. After tracheal intubation, patients will be kept with controlled ventilation.

Treatment:

Procedure: Controlled ventilation

Procedure: General anesthesia