Thrombectomy in Stroke Patients Without Prior Sedation : Frequency of intraprocedural Use of Analgosedation
Bibliographic record
Abstract
Background: In stroke patients with acute large vessel occlusion (LVO), endovascular therapy (EVT) may be performed with or without prior sedation. While several studies have evaluated patients treated under conscious sedation, only limited data are available on EVT performedwithout prior sedation. Our aim was to determine the proportion of non premedicated patients who will eventually require analgosedation during the procedure.Subjects and methods: We analyzed data from the prospective Montreal Neurovascular and Stroke Data Repository (MONSTER) on patients undergoing EVT for acute LVO without prior sedation for acute stroke treatment. Results: Between January and December 2018, 219 consecutive patients (mean age: 70 years SDu00b115, 52 % women) underwent EVT for acute LVO without prior sedation. Overall, medianprocedural time was 36 minutes (IQR 27-59) and recanalization (TICI 2b/3) was achieved in 184 (84%). One hundred and sixty-three procedures (74%) were completed without the use of any systemic analgosedation. Fifty-six patients (26%) required some sedation during the proceduresincluding 6 (3%) who required intubation. Proportions of favorable outcomes (mRS 0-2 at 90 days) did not differ whether patients received analgosedation during EVT or not (58.5% vs 57.0%, p=0.87).Conclusion: Our findings suggest thrombectomy without prior sedation is feasible in the majority of cases. Only one fourth of non-premedicated patients eventually require intraprocedural analgosedation and only rarely intubation. Further studies are needed to evaluate the impact of sedation on procedural parameters, patient comfort and stroke outcome.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.035 | 0.015 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.002 | 0.035 |
| Open science | 0.007 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".