Anesthesia for stroke rescue.

PURPOSE OF REVIEW: To highlight the potential implications of recent advances in the management of large vessel occlusions for intraprocedural anesthetic management.

RECENT FINDINGS: Stroke remains the leading cause of disability in the United States and the second leading cause of death in the world. Several randomized control trials published within the past decade have helped to make endovascular thrombectomy the standard of care for all eligible patients. However, whether intraprocedural anesthesia care practices may significantly improve in-hospital and out-of-hospital morbidity and mortality outcomes are not clear.

SUMMARY: Management strategies that shorten the time to intervention and maintain blood pressure to preserve penumbral tissue may be beneficial. Future well powered studies are necessary to enable inferences on what type of anesthetic management is harmless, neurotoxic, or neural plasticity promoting.