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Adenosine-induced cardiac standstill in intracranial aneurysm surgery: A case report
Geraldine Raphaela B. Jose1†* ,
Cristina C. Arcinue-Gomez1† ,
Lalaine O. Abainza1 ,
Katrina Xenia H. Figueroa-Piscawen1 ,
Glenn C. Chavez1 ,
Christian Rofem P. Quirimit1 ,
Gerardo D. Legaspi1
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1
Department of Anesthesiology, Division of Neuroanesthesia, University of the Philippines, Philippine General Hospital, Manila,
Philippines
Submitted: 9 April 2024 | Accepted: 31 July 2024 | Published: 26 August 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract
Surgical clipping of complex intracranial aneurysms can pose intraoperative challenges due to difficulty in anatomic exposure and uncontrolled intraoperative rupture, leading to significant morbidities or mortalities. This report presents a case of a 61-year-old Asian male with an unruptured saccular basilar tip aneurysm and an unruptured right middle cerebral artery aneurysm. The patient underwent a left temporal craniotomy and clipping of an unruptured basilar tip aneurysm, successfully achieved through adenosine-induced cardiac standstill. This technique reduces perfusion pressure and decreases the turgor of the aneurysm, thereby facilitating clip ligation. Our experience demonstrated that thorough, careful patient selection, optimal anesthetic management, and proper communication between neurosurgeon and anesthesiologist are important for achieving successful surgical outcomes.
Keywords
Adenosine-induced cardiac standstill
Complex intracranial aneurysm
Aneurysm clipping anesthesia
Adenosine cardiac arrest
Flow arrest in intracranial aneurysm
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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