Adenosine-Induced Transient Asystole

Britz, Gavin W.

doi:10.14797/mdcj-10-4-220

Cited by 15 publications

(7 citation statements)

References 26 publications

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“…El clipaje transitorio es una herramienta que se utiliza frecuentemente, aun así, hay ocasiones en las que no se puede aplicar como en el caso de aneurismas gigantes o profundos, en abordajes angostos o en base de cráneo donde la ligadura transitoria con clip podría obstaculizar aún más la visión del cirujano [6], [7], [8], [14]. En estos casos, el uso de adenosina podría mejorar la visión y el clipaje definitivo del aneurisma por la ausencia del clip transitorio, además que este último sólo disminuye el flujo sanguíneo desde una dirección, mientras que la hipotensión inducida por adenosina disminuye el flujo de manera global siendo en ocasiones más eficaz para la descompresión del aneurisma [20].…”

Section: Indicaciones De Adenosina En Cirugía De Aneurisma Cerebralunclassified

“…Los efectos más evidentes sobre el sistema respiratorio son a nivel del musculo liso bronquial donde puede producir broncoconstricción con el riesgo de broncoespasmo severo, por lo que se desaconseja su uso en pacientes con patología respiratoria severa, asmáticos o con enfermedad pulmonar obstructiva crónica [4], [14], [20].…”

Section: Contraindicaciones Del Uso De Adenosina En Aneurisma Cerebralunclassified

“…La adenosina exógena es rápidamente eliminada principalmente por captación a nivel del endotelio vascular y por eritrocitos; sin embargo, una porción puede ser metabolizada a ácido úrico aumentando sus niveles plasmáticos hasta en 15%, esta alza no es patológicamente significativa en pacientes sanos, sin embargo, es de consideración en pacientes que presentan defectos en el metabolismo de las purinas [4], [20].…”

Section: Contraindicaciones Del Uso De Adenosina En Aneurisma Cerebralunclassified

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Uso de asistolía inducida por adenosina de aneurismas cerebrales

F.¹,

K.²

2023

Rev. chil. anest.

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The treatment of cerebral aneurysms can currently be performed through endovascular technique and/or surgical treatment by clipping the aneurysm. The decision to use a particular technique will depend on the location, morphology and other characteristics. The techniques described are aimed to facilitate the surgical procedure, allowing to improve the approach, visualization and definitive clipping. Some of these techniques include temporary clipping of the proximal blood vessel, proximal control of the carotid artery at the cervical level, extracranial to intracranial bypass, and cardiac pause or arrest [4].

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Section: Indicaciones De Adenosina En Cirugía De Aneurisma Cerebralunclassified

Section: Contraindicaciones Del Uso De Adenosina En Aneurisma Cerebralunclassified

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Uso de asistolía inducida por adenosina de aneurismas cerebrales

F.¹,

K.²

2023

Rev. chil. anest.

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“… 22 Moreover, temporary clip ligation only decreases blood flow from one direction, while adenosine-induced hypotension is more global and, in certain instances, can more effectively decompress the aneurysmal dome. 23 …”

Section: Indications/strengthsmentioning

confidence: 99%

Adenosine to facilitate the clipping of cerebral aneurysms: literature review

2017

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Cerebral aneurysms have a high mortality rate when ruptured. Endovascular techniques have improved substantially in treating this pathology. However, surgical clip ligation remains the preferred option for some aneurysms. Various techniques are used intraoperatively to assist the surgeon in dissecting the aneurysmal dome free of surrounding tissue and placing a clip around the neck safely and effectively so that no nearby perforating vessels are affected and no residual remains. These techniques include temporary clip ligation, endovascular balloon occlusion and cardiac standstill. Adenosine use is one viable option for induced cardiac arrest leading to a short period of controlled hypotension. Its predictable course of action, rapid onset and offset and rare incidence of adverse side effects make it an attractive agent in this regard. Below, we provide an introduction to adenosine use, describing its pharmacokinetic properties, indications, contraindications, complications and future directions.

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“…[ 10 11 ] However, repeated dose bolus of adenosine increases the chance of side effect and complication and may result in asystole. [ 12 13 ] The controversial step arising regarding the efficacy and safety of the repeated third dose of Adenosine or to escalate it to 18 mg, or to switch earlier to the rate control medication e.g., (Diltiazem, Verapamil, Metoprolol). [ 4 14 15 ] Another medical treatment of PVST has been reported with amiodarone, procainamide, flecainide, propafenone, propranolol, sotalol, and quinidine, either alone or in combination.…”

Section: Introductionmentioning

confidence: 99%