PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

When stroke patients undergo surgery to remove blood clots, what anesthesia works best?

Anesthesiologists examine general anesthesia versus conscious sedation

2015-09-01
(Press-News.org) MAYWOOD, Ill. - In carefully selected patients, minimally invasive surgery is enabling physicians to stop strokes in their tracks. And as more stroke patients undergo such procedures, physicians are debating the best way to anesthetize them. Should patients be put under general anesthesia, rendering them unconscious and motionless? Or should they undergo conscious sedation, in which they remain conscious, but are sedated and do not feel pain? In the September, 2015 issue of the Journal of Stroke and Cerebrovascular Diseases, Loyola University Medical center anesthesiologists W. Scott Jellish, MD, PhD and Steven B. Edelstein, MD, detail the pros and cons of general anesthesia and conscious sedation. Dr. Jellish is a professor in and chair of the Department of Anesthesiology of Loyola University Chicago Stritch School of Medicine. Dr. Edelstein is a professor of and medical director for Perioperative Services in Loyola's Department of Anesthesiology.

Drs. Jellish and Edelstein conclude that regardless of which approach is used, an anesthesiologist or anesthesia care team should be present to provide sedation, deep sedation or general anesthesia. The neurointerventionalist is fully focused on the procedure and in many instances, not adequately directing the conscious sedation, Drs. Jellish and Edelstein write. "The anesthesia team is better equipped to handle procedural complications, hemodynamic control and airway emergencies that could occur during these endovascular procedures in critically ill patients." About 85 percent of strokes are ischemic, meaning they are caused by clots that block blood flow to the brain. The clot-busting drug tPA can restore blood flow, but it does not always work. In such cases, a new minimally invasive device called a stent retriever can be used to remove a clot. This minimally invasive treatment is known as endovascular therapy.

The physician inserts a catheter in an artery in the groin and guides it through various blood vessels up to the brain. The stent retriever is attached to a wire, which is guided through the catheter up to the blood clot. (A stent retriever is a self-expanding mesh tube, similar to stents used in heart patients.) When the stent retriever expands, it pushes the gelatinous blood clot against the wall of the blood vessel, immediately restoring blood flow. The stent retriever then is used to grab the clot and pull it out.

The paper by Drs. Jellish and Edelstein makes the case for both sedation and general anesthesia.

The case for sedation

Several retrospective studies have found that outcomes, including in-hospital mortality and pneumonia, appear better with sedation than with general anesthesia. Under conscious sedation, there is greater stability of blood pressure and blood flow. At a time when every minute counts, a delay may occur while waiting for an anesthesia care team to be put in place. After an ischemic stroke, about two million nerve cells die every ten minutes until blood flow is restored. Because the patient is conscious, it is possible to monitor the patient's neurologic status during the procedure, and make adjustments if necessary.

The case for general anesthesia

The patient is completely immobilized. "Immobility is extremely important when using small catheters in very complex locations such as the brainstem," Drs. Jellish and Edelstein write. The inhaled anesthetic drugs used in general anesthesia may provide neuroprotective effects. The inhaled drugs also can be used to control blood pressure. General anesthesia provides the ability to have a secured airway and to control carbon dioxide levels in the blood.

INFORMATION:



ELSE PRESS RELEASES FROM THIS DATE:

Self-driving golf carts

2015-09-01
At the International Conference on Intelligent Robots and Systems in September, members of the Singapore-MIT Alliance for Research and Technology (SMART) and their colleagues will describe an experiment conducted over six days at a large public garden in Singapore, in which self-driving golf carts ferried 500 tourists around winding paths trafficked by pedestrians, bicyclists, and the occasional monitor lizard. The experiments also tested an online booking system that enabled visitors to schedule pickups and drop-offs at any of 10 distinct stations scattered around the ...

Surge in Bicycle Injuries to Riders Over 45

2015-09-01
The incidence of bicycle accidents has increased significantly in the U.S. in recent years, with many serious injuries occurring among riders older than 45, according to a new study led by UC San Francisco. The researchers used a national injury surveillance database to study trends in bicycle injuries from 1998 to 2013. They found that the rate of hospital admissions associated with bicycle injuries more than doubled during that timeframe, especially with head and torso injuries. Altogether, the proportion of injuries occurring to riders above age 45 rose 81 percent, ...

Ancient hybridization key to domestic dog's origin, wolf conservation efforts

2015-09-01
KNOXVILLE--The ancestry of man's best friend may be more complicated than its furry coat and soulful eyes betray. Understanding the evolutionary history of the domesticated dog may ultimately help protect endangered wolves, according to a study from the University of Tennessee, Knoxville. Vladimir Dinets, research assistant professor of psychology, has published an overview examining the confusing and often misunderstood system used to classify dogs and related animals such as wolves and jackals. He has proposed a logical and scientifically sound classification scheme ...

New international standards needed to manage ocean noise

2015-09-01
DURHAM, N.C. -- As governments and industries expand their use of high-decibel seismic surveys to explore the ocean bottom for resources, experts from eight universities and environmental organizations are calling for new global standards and mitigation strategies. Their goal is to minimize the amount of sound the surveys produce and reduce risks the surveys and other underwater human noise pollution poses to vulnerable marine life. Firms and agencies conducting the surveys would benefit from these new measures, the experts assert, because instead of having to navigate ...

The more the merrier for animals that synchronize their behavior

2015-09-01
BUFFALO, N.Y. - Social interaction could be the mechanism that allows animals living in groups to synchronize their activities, whether it's huddling for warmth or offering protection from predators. This social presence affects the daily rhythm of activity and rest, and the larger the group, the greater the likelihood of synchronization, according to a study published recently in the journal Biology Letters. "At least in mice, and perhaps in other animals, this study shows quite dramatic synchrony amongst groups of animals that can only be explained by social interactions," ...

Economic security requires new measures of well-being

2015-09-01
BUFFALO, N.Y. - Economic well-being for low-income families in the U.S. is often determined by federal measures that establish basic requirements for essentials such as food, shelter and clothing, but a new study by a University at Buffalo research team suggests that such a definition is unrealistically narrow. To help families move out of poverty, the existing perspective of economic well-being and its short-term focus on basic needs should reflect possibilities for long-term stability, including a savings plan, rather than day-to-day survival, says Yunju Nam, an associate ...

Story tips from the Department of Energy's Oak Ridge National Laboratory, September 2015

2015-09-01
To arrange for an interview with a researcher, please contact the Communications staff member identified at the end of each tip. For more information on ORNL and its research and development activities, please refer to one of our media contacts. If you have a general media-related question or comment, you can send it to news@ornl.gov. MATERIALS - Solar bake test for NASA ... To test an instrument for a spacecraft that will fly closer to the sun than any before, engineers at Oak Ridge National Laboratory and the University of California-Berkeley used ORNL's powerful ...

To email or not to email? For those in love, it's better than leaving a voice message

2015-09-01
BLOOMINGTON, Ind. -- In her hit single, Carly Rae Jepsen may have sung, "Here's my number, so call me maybe." But according to a new research study from Indiana University, she might be more successful in finding love if she asked him to send her an email. The research, which has been accepted for publication in the journal Computers in Human Behavior, suggests that, in this digital age, an email can be more effective in expressing romantic feelings than leaving a voicemail message. Previous research and conventional wisdom suggested the opposite, that a voicemail message ...

How much liposuction is 'safe'? The answer varies by body weight

2015-09-01
September 1, 2015 - What's the "safe" amount of fat to remove in patients undergoing liposuction? Rather than a hard-and-fast rule, the answer depends on the patient's body mass index (BMI), according to a report in the September issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). "Our study shows that liposuction is associated with a very low complication rate, with major complications occurring in less than 1 in 1,000 patients," comments ASPS Member Surgeon John Y.S. Kim of Northwestern ...

Yeast study yields insights into cell-division cycle

2015-09-01
ANN ARBOR--Studies using yeast genetics have provided new, fundamental insights into the cell-division cycle, researchers at the University of Michigan Life Sciences Institute report. Findings published Aug. 31 in the journal eLife show that an organelle known as the vacuole, which performs a variety of cellular housekeeping functions, plays an essential role in the initiation of the cell-division cycle. The cell-division cycle, also known simply as the cell cycle, is the series of events inside a cell that leads to its division. "The yeast vacuole has a counterpart ...

LAST 30 PRESS RELEASES:

Resistance training may improve nerve health, slow aging process, study shows

Common and inexpensive medicine halves the risk of recurrence in patients with colorectal cancer

SwRI-built instruments to monitor, provide advanced warning of space weather events

Breakthrough advances sodium-based battery design

New targeted radiation therapy shows near-complete response in rare sarcoma patients

Does physical frailty contribute to dementia?

Soccer headers and brain health: Study finds changes within folds of the brain

Decoding plants’ language of light

UNC Greensboro study finds ticks carrying Lyme disease moving into western NC

New implant restores blood pressure balance after spinal cord injury

New York City's medical specialist advantage may be an illusion, new NYU Tandon research shows

Could a local anesthetic that doesn’t impair motor function be within reach?

1 in 8 Italian cetacean strandings show evidence of fishery interactions, with bottlenose and striped dolphins most commonly affected, according to analysis across four decades of data and more than 5

In the wild, chimpanzees likely ingest the equivalent of several alcoholic drinks every day

Warming of 2°C intensifies Arctic carbon sink but weakens Alpine sink, study finds

Bronze and Iron Age cultures in the Middle East were committed to wine production

Indian adolescents are mostly starting their periods at an earlier age than 25 years ago

Temporary medical centers in Gaza known as "Medical Points" (MPs) treat an average of 117 people daily with only about 7 staff per MP

Rates of alcohol-induced deaths among the general population nearly doubled from 1999 to 2024

PLOS One study: In adolescent lab animals exposed to cocaine, High-Intensity Interval Training boosts aversion to the drug

Scientists identify four ways our bodies respond to COVID-19 vaccines

Stronger together: A new fusion protein boosts cancer immunotherapy

Hidden brain waves as triggers for post-seizure wandering

Music training can help the brain focus

Researcher develop the first hydride ion prototype battery

MIT researchers find a more precise way to edit the genome

‘Teen’ pachycephalosaur butts into fossil record

Study finds cocoa extract supplement reduced key marker of inflammation and aging

Obesity treatment with bariatric surgery vs GLP-1 receptor agonists

Nicotinamide for skin cancer chemoprevention

[Press-News.org] When stroke patients undergo surgery to remove blood clots, what anesthesia works best?
Anesthesiologists examine general anesthesia versus conscious sedation