Cardiac arrest after intracisternal papaverine instillation during intracranial aneurysm surgery. Case report

J Neurosurg. 2010 Oct;113(4):760-2. doi: 10.3171/2009.11.JNS09899.

Abstract

Cerebral vasospasm induced by aneurysmal subarachnoid hemorrhage is still a leading cause of morbidity and death. This 50-year-old man underwent surgery for aneurysm clipping. After the aneurysm was clipped, papaverine was instilled into the surgical area. Bradycardia, hypotension, and sinus arrest developed in the first minute after applying the papaverine. Thus, the authors concluded that the application of papaverine to the surgical area can result in fatal bradycardia and hypotension.

Publication types

  • Case Reports

MeSH terms

  • Bradycardia / chemically induced
  • Cisterna Magna
  • Fatal Outcome
  • Glasgow Coma Scale
  • Heart Arrest / chemically induced*
  • Hemodynamics / physiology
  • Humans
  • Hypotension / chemically induced
  • Injections
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Papaverine / administration & dosage*
  • Papaverine / adverse effects*
  • Sinus Arrest, Cardiac / chemically induced
  • Subarachnoid Hemorrhage / surgery
  • Vasodilator Agents / administration & dosage*
  • Vasodilator Agents / adverse effects*

Substances

  • Vasodilator Agents
  • Papaverine