Anaesthesiological Care for Stroke Patients during endovascular Thrombectomy: State of Practice and Science

Background: The number of people in Germany who have a form of therapy limitation has increased in recent years. Accordingly, patients with treatment limitations will be increasingly seen perioperatively. In the past, it was recommended that therapeutic limitations should be automatically suspended in the perioperative period. Currently, an individual approach with the possibility to uphold the limitation is considered appropriate. In the scope of our study, the attitude of German anaesthetists toward this topic was to be surveyed using an internet-based questionnaire. Methods: The members of the DGAI were invited to participate in the survey by e-mail. The survey included the topics of general information, preoperative interview, intraoperative scenarios, decision making, and possible solutions. The results of the survey were presented and analysed relative to the level of specialty training of the participants. Results: 1,112 participants answered the survey completely. With a specialist rate of 84.9 %, there were statistically significant differences in the intraoperative handling of a resuscitation situation with patients who refused resuscitation measures, depending on patient factors, the circumstances that led to resuscitation measures and the participants' level of specialty training. Doctors undergoing training showed more uncertainties regarding perioperative therapeutic limitations and had a higher preference for perioperative management. Conclusions: The survey reflects an opinion of German anaesthetists on how to deal with perioperative therapeutic limitations. A management recommendation for perioperative therapeutic limitations seems sensible in order to reduce uncertainties and strengthen the patient's autonomy.