General Anesthesia May Lead to Better Outcomes in Stroke Thrombectomy?
Fawaz Al-Mufti, Associate Dean for Research and Innovation at Westchester Medical Center, shared a post on LinkedIn:
“SEGA says… GAME OVER for the GA vs Sedation debate.
May be?
Fresh in JAMA Neurology, the SEGA Randomized Trial put general anesthesia head-to-head with moderate sedation for mechanical thrombectomy in large vessel occlusion stroke, giving us some randomized clarity on an age-old debate in stroke thrombectomy: GA or sedation?
260 patients, 10 U.S. stroke centers, randomized head-to-head.
Randomized 1:1 GA vs sedation
At 90 days: GA favored with OR 1.22 (CrI 0.79–1.87), 81% probability of superiority
Reperfusion: higher with GA (69% probability)
Symptomatic ICH: 0.8% GA vs 2.4% sedation
Translation: GA pulled ahead with better 90-day outcomes and higher reperfusion rates.
Safety? Pretty comparable.
Bottomline: putting patients to sleep may actually wake up better outcomes.
Congrats to the SEGA investigators and P. Roc Chen, MD, FAANS, FACS for turning a long-running debate into data.”
Title: Sedation vs General Anesthesia for Endovascular Therapy in Acute Ischemic Stroke
Authors: Peng Roc Chen, Carlos A. Artime, Sunil A. Sheth, Claudia Pedroza, Santiago Ortega-Gutierrez, Stacey Wolfe, Clark Sitton, Peter Kan, Omar Tanweer, Alex Chebl, Clemens M. Schirmer, Jay T. Morrow, Yazan J. Alderazi, Bradley Bohnstedt, Kadir Erkmen, Edgar A. Samaniego, Elena Garrido, Sean I. Savitz, Allison Engstrom, Eddie Aguilar, Tien Nguyen, Andrew D. Barreto
Read the full article here.
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