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Adenosine-induced cardiac arrest during intraoperative cerebral aneurysm rupture.
- Source :
-
World neurosurgery [World Neurosurg] 2010 Feb; Vol. 73 (2), pp. 79-83; discussion e9. Date of Electronic Publication: 2009 Oct 08. - Publication Year :
- 2010
-
Abstract
- Background: Rupture of an intracranial aneurysm during surgical clipping may have devastating consequences. Should this happen all methods ought to be considered to stop the bleeding. A short-term cardiac arrest induced by adenosine could be a feasible method to help the surgeon. We present our experiences in the administration of adenosine during an intraoperative aneurysm rupture.<br />Methods: Medical records of patients who underwent surgical clipping of a cerebral arterial aneurysm were reviewed from 2 university hospitals' operative database in the years 2003 to 2008. Patients were included in this study if adenosine had been administered during intraoperative rupture of an aneurysm.<br />Results: Altogether, 16 of 1014 patients were identified with the use of adenosine during an intraoperative rupture of an aneurysm. All of the patients had sinus rhythm and normotension before the rupture of the aneurysm. Twelve patients were administered a single dose of adenosine and 4 multiple boluses for induction of cardiac arrest; the median (range) total dose was 12 (6-18) mg and 27 (18-87) mg, respectively. The clipping of the aneurysm and the recovery of circulation were uneventful in all cases. In a subgroup analysis according to patient outcome as alive/dead, the pre- and postoperative neurologic condition correlated with the outcome, whereas adenosine did not have any effect on the patient outcome.<br />Conclusion: In a case of a sudden aneurysm rupture, adenosine-induced circulatory arrest could be a safe option to facilitate clipping of an aneurysm. However, if adenosine is used, a very close collaboration between the surgeon and the anesthesiologist is required.<br /> (Copyright © 2010 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aneurysm, Ruptured complications
Aneurysm, Ruptured mortality
Cohort Studies
Female
Humans
Intracranial Aneurysm complications
Intracranial Aneurysm mortality
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Adenosine therapeutic use
Aneurysm, Ruptured surgery
Anti-Arrhythmia Agents therapeutic use
Heart Arrest, Induced
Hemostasis, Surgical
Intracranial Aneurysm surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 73
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 20860932
- Full Text :
- https://doi.org/10.1016/j.surneu.2009.06.018