Adenosine-induced cardiac standstill in intracranial aneurysm surgery: A case report

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.