The time when hypotension occurs may be important in the management of intraarterial thrombolysis for stroke

摘要

The contributions of general anesthesia and blood pressure management, either independently or together, to adverse outcome from intraarterial thrombolysis for stroke may be important. Davis etal. have attempted to study this through a retrospective analysis of their patient experience. They concluded "that patients managed with general anesthesia, and its concomitant relative systolic hypotension, during en-dovascular therapy for acute ischemic stroke have a much lower likelihood of good neurologic outcome, compared to patients managed with local anesthesia." We note, however, that die lowest average systolic blood pressure in the general anesthesia group, 104 +- 17 mmHg, is exactly the same as the baseline systolic blood pressure. Baseline measurements are usually those made at some time-point before the initiation of general anesthesia, e.g., in the emergency department, the preoperative area, or the first blood pressure on arrival in the operating room.