Anaesthesia-related complications after endovascular therapy for acute ischaemic stroke under general anaesthesia with early extubation: A single-centre retrospective cohort study

Background: The optimal anaesthetic strategy for endovascular therapy (EVT) in acute ischaemic stroke (AIS) remains debated. We evaluated the incidence of anaesthesia-related complications, their predictors, and the associated clinical outcomes of a standardised general anaesthesia (GA) protocol. Methods: 3-6), change in 24-h National Institutes of Health Stroke Scale (NIHSS), pneumonia rate, and 3-month mortality. Results: Of 734 patients, 133 (18%) experienced an anaesthesia-related complication and had a complicated course. Admission NIHSS, younger age, and posterior circulation occlusion were the strongest predictors. These patients had smaller 24-h NIHSS improvement (mean difference 5.4, 95% confidence interval [CI] 4.1-6.7), higher pneumonia risk (odd ratio [OR]: 2.72, 95% CI: 1.66-4.48), poorer functional outcomes (mRS: 3-6; OR: 3.65, 95% CI: 2.15-6.20), and higher mortality (OR: 4.20, 95% CI: 2.45-7.21) compared with those with an uncomplicated course. Conclusions: Complications occurred in 133 (18%) patients and were more frequent in those with higher NIHSS scores and posterior circulation occlusions. Patients with a complicated course had poorer functional outcomes at 3 months.