Intracisternal papaverine toxicity in anterior circulation aneurysm clipping surgery
Introduction. Cerebral vasospasm is a major cause of mortality in patients with subarachnoid haemorrhage. Irrigation of intracisternal papaverine has been adopted as a strategy to reduce the incidence of aneurysm-surgery-associated vasospasm. Aim. The aim of this literature review is to summarize...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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London Academic Publishing
2020-09-01
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| Series: | Romanian Neurosurgery |
| Subjects: | |
| Online Access: | https://www.journals.lapub.co.uk/index.php/roneurosurgery/article/view/1584 |
| _version_ | 1811268056537628672 |
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| author | Zahraa F. Al-Sharshahi Samer S. Hoz Mustafa E. Almurayati Zahraa M. Kareem Zahraa Ameen |
| author_facet | Zahraa F. Al-Sharshahi Samer S. Hoz Mustafa E. Almurayati Zahraa M. Kareem Zahraa Ameen |
| author_sort | Zahraa F. Al-Sharshahi |
| collection | DOAJ |
| description | Introduction. Cerebral vasospasm is a major cause of mortality in patients with subarachnoid haemorrhage. Irrigation of intracisternal papaverine has been adopted as a strategy to reduce the incidence of aneurysm-surgery-associated vasospasm.
Aim. The aim of this literature review is to summarize the reported complications associated with intracisternal papaverine administration.
Patients and Methods. We searched the following databases: PubMed, Google Scholar, Cochrane Library, Clinical Key, Embase, Emerald, Health Business Elite, MEDLINE at OVID, EBM Reviews and Research Gate. The following keywords were used: Intracisternal papaverine, topical papaverine, direct papaverine, a vasodilator for aneurysm surgery, papaverine in aneurysm clipping, papaverine complications and papaverine side effects. The search criteria included all articles published between 1980-2019, in the English language.
Results. Our search yielded a total of 19 articles describing 43 cases. The most common reported complication was ipsilateral oculomotor nerve palsy. Other local complications included: Bilateral oculomotor nerve palsy, ipsilateral facial nerve palsy, and monocular blindness. Although less common, reports pointing to papaverine systemic toxicity did exist. Examples of such complications included: Profound hypotension, bradycardia, hypertension and tachycardia, hyperthermia and metabolic acidosis, cardiac arrest and even death.
Conclusion. Intracisternal papaverine irrigation is an effective strategy in reducing peri-operative vasospasm associated with aneurysm surgery. Although uncommon, both local and systemic side effects have been linked to papaverine use, calling for careful dosing and close monitoring to enhance its safety profile. |
| first_indexed | 2024-04-12T21:13:52Z |
| format | Article |
| id | doaj.art-8894148e4b7b42cdbc1c454924ab070f |
| institution | Directory Open Access Journal |
| issn | 1220-8841 2344-4959 |
| language | English |
| last_indexed | 2024-04-12T21:13:52Z |
| publishDate | 2020-09-01 |
| publisher | London Academic Publishing |
| record_format | Article |
| series | Romanian Neurosurgery |
| spelling | doaj.art-8894148e4b7b42cdbc1c454924ab070f2022-12-22T03:16:30ZengLondon Academic PublishingRomanian Neurosurgery1220-88412344-49592020-09-0134310.33962/roneuro-2020-060Intracisternal papaverine toxicity in anterior circulation aneurysm clipping surgeryZahraa F. Al-SharshahiSamer S. HozMustafa E. AlmurayatiZahraa M. KareemZahraa AmeenIntroduction. Cerebral vasospasm is a major cause of mortality in patients with subarachnoid haemorrhage. Irrigation of intracisternal papaverine has been adopted as a strategy to reduce the incidence of aneurysm-surgery-associated vasospasm. Aim. The aim of this literature review is to summarize the reported complications associated with intracisternal papaverine administration. Patients and Methods. We searched the following databases: PubMed, Google Scholar, Cochrane Library, Clinical Key, Embase, Emerald, Health Business Elite, MEDLINE at OVID, EBM Reviews and Research Gate. The following keywords were used: Intracisternal papaverine, topical papaverine, direct papaverine, a vasodilator for aneurysm surgery, papaverine in aneurysm clipping, papaverine complications and papaverine side effects. The search criteria included all articles published between 1980-2019, in the English language. Results. Our search yielded a total of 19 articles describing 43 cases. The most common reported complication was ipsilateral oculomotor nerve palsy. Other local complications included: Bilateral oculomotor nerve palsy, ipsilateral facial nerve palsy, and monocular blindness. Although less common, reports pointing to papaverine systemic toxicity did exist. Examples of such complications included: Profound hypotension, bradycardia, hypertension and tachycardia, hyperthermia and metabolic acidosis, cardiac arrest and even death. Conclusion. Intracisternal papaverine irrigation is an effective strategy in reducing peri-operative vasospasm associated with aneurysm surgery. Although uncommon, both local and systemic side effects have been linked to papaverine use, calling for careful dosing and close monitoring to enhance its safety profile.https://www.journals.lapub.co.uk/index.php/roneurosurgery/article/view/1584Intracisternal papaverine toxicityanterior circulation aneurysmclipping surgery |
| spellingShingle | Zahraa F. Al-Sharshahi Samer S. Hoz Mustafa E. Almurayati Zahraa M. Kareem Zahraa Ameen Intracisternal papaverine toxicity in anterior circulation aneurysm clipping surgery Romanian Neurosurgery Intracisternal papaverine toxicity anterior circulation aneurysm clipping surgery |
| title | Intracisternal papaverine toxicity in anterior circulation aneurysm clipping surgery |
| title_full | Intracisternal papaverine toxicity in anterior circulation aneurysm clipping surgery |
| title_fullStr | Intracisternal papaverine toxicity in anterior circulation aneurysm clipping surgery |
| title_full_unstemmed | Intracisternal papaverine toxicity in anterior circulation aneurysm clipping surgery |
| title_short | Intracisternal papaverine toxicity in anterior circulation aneurysm clipping surgery |
| title_sort | intracisternal papaverine toxicity in anterior circulation aneurysm clipping surgery |
| topic | Intracisternal papaverine toxicity anterior circulation aneurysm clipping surgery |
| url | https://www.journals.lapub.co.uk/index.php/roneurosurgery/article/view/1584 |
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