Patients with ischemic stroke Circulatory System
Conditions
Interventions
1. Preoperative Assessment (24 h Before Surgery)
Anxiety and depression were evaluated using HADS-A and HADS-D. Cognitive function was assessed by MoCA and MMSE. Neurological impairment was scored wit
maintenance with remimazolam 0.2–0.5 mg·kg?¹·h?¹ (BIS 40–60), discontinued 30 min before surgery. Group Dex: Loading dose of dexmedetomidine 0.5 µg/kg iv 10 min before induction
maintenance with 0.2 µg·kg?¹·h?¹ (BIS 40–60), discontinued 30 min before surgery. Group C: Routine propofol-based anesthesia without remimazolam or dexmedetomidine.
Anesthesia induction: Propofol 2–3
orotracheal intubation (depth 22–24 cm) followed by mechanical ventilation (FiO2 30%, RR 10–12 breaths/min, I:E 1:2–2.5, VT 8–12 mL/kg, ETCO2 35–45 mmHg). Anesthesia maintenance: Propofol 4–12 mg·kg?¹
additional sufentanil 0.2 µg/kg before skin incision
BIS maintained at 40–60, with dosage adjusted according to vital signs. Fluid therapy included lactated Ringer’s solution and 6% hydroxyethyl starch.
Anesthesia emergence: Neuromuscular blockade rever
Sponsors
People's Hospital of Xinjiang Uygur Autonomous Region
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Diagnosis of acute anterior circulation ischemic stroke (internal carotid artery / M1–M2 segment of middle cerebral artery), with penumbra confirmed by CTP/MRP 2. Age 18–80 years, no gender restriction, ASA physical status I–III 3. Admission within 24 hours of symptom onset 4. NIHSS score 4–15 (mild-to-moderate neurological injury[7]), mRS score =4 5. No preoperative history of anxiety/depression (HADS score =7) or cognitive impairment (MoCA =26, MMSE =24) 6. Prior to the study, the patient or legal representative understood and voluntarily signed the informed consent approved by the ethics committee, agreed to randomization, and cooperated with follow-up
Exclusion criteria
Exclusion criteria: 1. Diagnosis of global aphasia, transient ischemic attack, visual or auditory impairment, or severe dementia (MMSE 70 mL); complicated with intracranial hemorrhage (type PH2 hematoma) or mass effect 9. Anesthesia-related exclusion: difficult airway, severe intraoperative hypotension (MAP 10 minutes), or requirement for high-dose vasoactive drugs
Countries
China
Contacts
Public ContactNan Chen
Outcome results
None listed