Inhalational versus intravenous anesthetic  for cerebrovascular accident outcomes after surgical revascularization for adult Moyamoya disease

Inhalational versus intravenous anesthetic for cerebrovascular accident outcomes after surgical revascularization for adult Moyamoya disease | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Inhalational versus intravenous anesthetic for cerebrovascular accident outcomes after surgical revascularization for adult Moyamoya disease Yifei Cheng, Chaochao Zha, Xuehua Che, Yingwei Wang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4609181/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 15 Feb, 2025 Read the published version in BMC Anesthesiology → Version 1 posted 14 You are reading this latest preprint version Abstract Purpose: To compare the effects of inhalational anesthetics and intravenous anesthetics on the neurological function of patients with moyamoya disease (MMD) after vascular bypass surgery. Methods: The clinical anesthesia data of patients were retrospectively collected. Patients who underwent bypass grafts with general anesthesia from January 1st, 2019, to December 31st, 2020, in Huashan Hospital affiliated with Fudan University, were selected. The primary endpoint was stroke incidence within seven days after anesthesia, and the secondary endpoints included hyperperfusion syndrome (HPS) and incidence of postoperative seizure. Results: We compared the data of MMD patients who received inhalational anesthetics (Sevoflurane anesthetics ,n = 199, group S) and intravenous anesthetics (Propofol anesthetics , n = 219，group P). The stroke incidence in the two groups (group S vs. group P) was 6.6% vs. 5.9% (OR = 0.835; 95% CI, 0.388-1.797; p = 0.841), and the group S vs. group P of HPS incidence was 32.5% vs. 31.1% (OR=0.942; 95% CI, 0.636-0.1.397, p = 0.753). At discharge, anesthetics didn't affect the neurological endpoint. There were statistical no differences in the NHISS score (p50:S group vs. P group = 2:1, p=0.082) at 7 days after surgery, but mRS score (p50:S group vs. P group = 2:1, p<0.001) at 7 days after surgery, as well as the mRS score at 6 months of follow-up (p50:S group vs. P group=0:0, p<0.001) have tatistical differences. Conclusion: Our data indicated that both inhalational and intravenous anesthetics had protective effects on patients who underwent MMD bypass grafts. MMD patients who received inhalational anesthetics and intravenous anesthetics had similar odds of neurological deficits. When comparing long-term clinical data, most patients experience good neurological recovery after receiving inhalation or intravenous anesthesia, but when compared mRS score p75（S group vs. P group = 3:1）in 6 month intravenous anesthetics might be more suitable for patients undergoing MMD bypass grafts. Keywords: Moyamoya disease; Surgical therapy; Anesthesia; Sevoflurane; Propofol Moyamoya disease Surgical therapy Anesthesia Sevoflurane Propofol Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 15 Feb, 2025 Read the published version in BMC Anesthesiology → Version 1 posted Editorial decision: Revision requested 15 Jan, 2025 Reviews received at journal 03 Aug, 2024 Reviews received at journal 03 Aug, 2024 Reviewers agreed at journal 27 Jul, 2024 Reviewers agreed at journal 26 Jul, 2024 Reviewers agreed at journal 26 Jul, 2024 Reviews received at journal 07 Jul, 2024 Reviewers agreed at journal 04 Jul, 2024 Reviewers agreed at journal 04 Jul, 2024 Reviewers invited by journal 03 Jul, 2024 Editor invited by journal 03 Jul, 2024 Editor assigned by journal 26 Jun, 2024 Submission checks completed at journal 25 Jun, 2024 First submitted to journal 20 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4609181","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":325851026,"identity":"79f62726-a998-4ea0-9584-8aaee43655b5","order_by":0,"name":"Yifei Cheng","email":"","orcid":"","institution":"Huashan Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yifei","middleName":"","lastName":"Cheng","suffix":""},{"id":325851027,"identity":"8e7ca659-f2ba-4793-9f9b-6c534ebf4da9","order_by":1,"name":"Chaochao Zha","email":"","orcid":"","institution":"Huashan Hospital","correspondingAuthor":false,"prefix":"","firstName":"Chaochao","middleName":"","lastName":"Zha","suffix":""},{"id":325851028,"identity":"e14ec76e-dab5-44fc-a362-8f395b9c86e4","order_by":2,"name":"Xuehua Che","email":"","orcid":"","institution":"Huashan Hospital","correspondingAuthor":false,"prefix":"","firstName":"Xuehua","middleName":"","lastName":"Che","suffix":""},{"id":325851029,"identity":"9a8b7f82-d1b3-438b-8ca1-7aea107439bb","order_by":3,"name":"Yingwei Wang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3ElEQVRIiWNgGAWjYBACgwNgyoafgSEBxGAmWkuaZAOpWg6TouX42cOvedvOSxgcT372gKHCOrGB/ewBvFrMzuSlWfO23ZYwOPPM3IDhTHpiA09eAn4tB3LMjHm33a4zuJFgJsHYdjixQYLHAL+W829AWs5JGNxI/ybB+I8ILfY3cowf8247ANSSA7SlgQgtljfemDHO/ZcsIXnmTZlEwrF04zaeHPxaDM7nGH94c8ZOgu94+jaJDzXWsv3sZ/BrAQI2KR4YMwHEJaQeCJg//iBC1SgYBaNgFIxgAACYDEq1viCEVQAAAABJRU5ErkJggg==","orcid":"","institution":"Huashan Hospital","correspondingAuthor":true,"prefix":"","firstName":"Yingwei","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2024-06-20 05:02:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4609181/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4609181/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12871-025-02958-7","type":"published","date":"2025-02-15T15:58:03+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":76488164,"identity":"b75ab048-08e8-4c96-9021-6877fd54693b","added_by":"auto","created_at":"2025-02-17 16:13:25","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":454468,"visible":true,"origin":"","legend":"","description":"","filename":"revisedmanuscript2024620.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4609181/v1_covered_ac52582e-5f66-45cb-bdb3-1f3187b4196b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Inhalational versus intravenous anesthetic for cerebrovascular accident outcomes after surgical revascularization for adult Moyamoya disease","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-anesthesiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bane","sideBox":"Learn more about [BMC Anesthesiology](http://bmcanesthesiol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bane","title":"BMC Anesthesiology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Moyamoya disease, Surgical therapy, Anesthesia, Sevoflurane, Propofol","lastPublishedDoi":"10.21203/rs.3.rs-4609181/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4609181/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePurpose: To compare the effects of inhalational anesthetics and intravenous anesthetics on the neurological function of patients with moyamoya disease (MMD) after vascular bypass surgery.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: The clinical anesthesia data of patients were retrospectively collected. Patients who underwent bypass grafts with general anesthesia from January 1st, 2019, to December 31st, 2020, in Huashan Hospital affiliated with Fudan University, were selected. The primary endpoint was stroke incidence within seven days after anesthesia, and the secondary endpoints included hyperperfusion syndrome (HPS) and incidence of postoperative seizure.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: We compared the data of MMD patients who received inhalational anesthetics (Sevoflurane anesthetics ,n = 199, group S) and intravenous anesthetics (Propofol anesthetics , n = 219，group P). The stroke incidence in the two groups (group S vs. group P) was 6.6% vs. 5.9% (OR = 0.835; 95% CI, 0.388-1.797; p = 0.841), and the group S vs. group P of HPS incidence was 32.5% vs. 31.1% (OR=0.942; 95% CI, 0.636-0.1.397, p = 0.753). At discharge, anesthetics didn't affect the neurological endpoint. There were statistical no differences in the NHISS score (p50:S group vs. P group = 2:1, p=0.082) at 7 days after surgery, but mRS score (p50:S group vs. P group = 2:1, p\u0026lt;0.001) at 7 days after surgery, as well as the mRS score at 6 months of follow-up (p50:S group vs. P group=0:0, p\u0026lt;0.001)\u0026nbsp; have tatistical\u0026nbsp; differences.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Conclusion: Our data indicated that both inhalational and intravenous anesthetics had protective effects on patients who underwent MMD bypass grafts. MMD patients who received inhalational anesthetics and intravenous anesthetics had similar odds of neurological deficits. When comparing long-term clinical data, most patients experience good neurological recovery after receiving inhalation or intravenous anesthesia, but when compared mRS score\u0026nbsp; p75（S group vs. P group = 3:1）in 6 month intravenous anesthetics might be more suitable for patients undergoing MMD bypass grafts. Keywords: Moyamoya disease; Surgical therapy; Anesthesia; Sevoflurane; Propofol\u003c/p\u003e","manuscriptTitle":"Inhalational versus intravenous anesthetic for cerebrovascular accident outcomes after surgical revascularization for adult Moyamoya disease","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-17 18:18:08","doi":"10.21203/rs.3.rs-4609181/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-01-15T06:52:26+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-04T02:15:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-03T04:01:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"323265262924324153320659735473473145521","date":"2024-07-27T05:44:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"315961266650721984925031638693391078540","date":"2024-07-27T02:16:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"337564751094037710730822894833969996140","date":"2024-07-27T00:51:55+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-07T22:25:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"120629990950559326446254902191178571994","date":"2024-07-04T13:59:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"247646433049432491872890164716738604854","date":"2024-07-04T08:13:42+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-03T11:36:43+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-07-03T10:45:13+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-26T07:05:28+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-25T06:54:21+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Anesthesiology","date":"2024-06-20T05:01:14+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-anesthesiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bane","sideBox":"Learn more about [BMC Anesthesiology](http://bmcanesthesiol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bane","title":"BMC Anesthesiology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ca640cd8-1e66-4fa7-a757-138a76e429f6","owner":[],"postedDate":"July 17th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-02-17T16:10:26+00:00","versionOfRecord":{"articleIdentity":"rs-4609181","link":"https://doi.org/10.1186/s12871-025-02958-7","journal":{"identity":"bmc-anesthesiology","isVorOnly":false,"title":"BMC Anesthesiology"},"publishedOn":"2025-02-15 15:58:03","publishedOnDateReadable":"February 15th, 2025"},"versionCreatedAt":"2024-07-17 18:18:08","video":"","vorDoi":"10.1186/s12871-025-02958-7","vorDoiUrl":"https://doi.org/10.1186/s12871-025-02958-7","workflowStages":[]},"version":"v1","identity":"rs-4609181","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4609181","identity":"rs-4609181","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}