Background and Goal of Study: Acute stroke is the leading cause of long-term disability worldwide. Acute ischaemic stroke (AIS) is responsible for 87% of the cases. Anaesthetic management for AIS endovascular treatment has been shown to affect outcomes. It seems that patients who receive general anaesthesia have worse outcomes compared to those who receive sedation/local anaesthesia. This may be related to lower blood pressures (BP) during general anaesthesia. The actual ranges at which BP should be kept are specific to the patient's baseline and the characteristics of the stroke and cerebral vasculature, and are subject of ongoing investigation. The Society for Neuroscience in Anesthesiology and Critical Care recommends systolic BP (SBP) >140 mmHg and <180 mmHg upon recanalization. The purpose of our study is to analyze whether the target SBP was achieved when different anaesthetic techniques were used for the management of patients with AIS. 
Materials and Methods: Retrospective analysis of patients who underwent thrombectomy for AIS from 2016 to 2017. Data collected from anaesthesia records. Patient who underwent successful thrombectomy with a registered time of recanalization were included. Cases of unsuccessful recanalization, complications during the procedure or lack of records were excluded. From the 53 medical records collected, 36 were considered for analysis. The final sample was divided in two groups. Group A: patients undergoing general anaesthesia and group B: patients undergoing sedoanalgesia/local anaesthesia. For each patient, first SBP value and SBP values recorded during the procedure upon recanalization were registered. Mean first SBP and mean SBP during the procedure were calculated for each group.  
Results and Discussion: Group A (n=23): mean first SBP: 163,95 mmHg ± 29,59 (95% CI 151,85 - 176,05); mean SBP during the procedure: 118,78 mmHg ± 15,00 (95% CI 112,65 - 124,91). Group B (n=13): mean first SBP: 160,30 mmHg ± 22,13 (95% CI 148,27 - 172,33); mean SBP during the procedure: 148,15 mmHg ± 17,06 (95% CI 138,87 - 157,42).
Conclusions: In our sample, target SBP was not achieved in group A. Our results suggest that general anaesthesia is associated with lower SBP during thrombectomy in AIS. General anesthesia has many advantages and should be used when indicated but careful intraprocedural BP monitoring and treatment are crucial to maximize the benefits of endovascular treatment.

12 / Time is brain, pressure is brain, anaesthesia matters: a retrospective analysis of blood pressure management during thrombectomy for acute ischaemic stroke