Advantages and Limitations of Anesthesia and Sedation Practices Used Among Acute Ischemic Stroke Patients during Endovascular Revascularization Therapy
Date of Graduation
Doctor of Nursing Practice (DNP)
Dr. Karen Van Leuven
Dr. Elena Capella
Dr. Susan Prion
In order to safely and efficiently perform endovascular revascularization procedures among acute ischemic stroke (AIS) patients, general anesthesia or sedation is often required. However, anesthesia management during these procedures varies significantly worldwide and the procedural logistics have not been established yet. At some institutions AIS patients are intubated and paralyzed, while at other facilities, there is no routine protocol. In 2011 the University Hospital used “action nurses” (critical care float pool nurses) to provide pharmacological paralysis with sedation for intubated AIS patients under direct supervision of the neurointerventionalist. However, clinical outcomes among AIS patients undergoing endovascular procedures were poor. Exclusive utilization of the anesthesia team services for this patient population regardless of the anesthesia management modality chosen (sedation vs. general anesthesia) was introduced in November 2012. Implementation of this project helped to improve functional outcomes (as measured by a modified Rankin scale) among AIS patients undergoing endovascular revascularization therapy by 26.5% at 30-days follow up as compared to previous.
Korzewski, Margaret, "Advantages and Limitations of Anesthesia and Sedation Practices Used Among Acute Ischemic Stroke Patients during Endovascular Revascularization Therapy" (2014). Doctor of Nursing Practice (DNP) Projects. 24.