In this case, Intraoperative rupture of an intracranial aneurysm is a life-threatening situation that carries a high risk of morbidity and mortality. Since 2000, adenosine has been used successfully to induce transient hypotension and asystole to control bleeding and facilitate surgical clipping of aneurysms that rupture intraoperatively. Given the lack of reports describing this method in a limited number of patients, we performed a systematic review of the literature detailing this technique’s use and outcomes. The authors conducted a systematic review and identified all studies in which adenosine was used to set an intracranial aneurysm that ruptured intraoperatively. We then determined overall morbidity and mortality rates, adding six of our patients.

The doctors and researchers analyzed the collected data for 29 patients, including 23 previously reported patients from the literature and six additional cases from our own experience. Most patients presented with subarachnoid hemorrhage (SAH). The adenosine-induced circulatory arrest appears to safely control intraoperative bleeding and facilitate the clipping of ruptured intracranial aneurysms based on the limited published literature available. Further studies comparing patient outcomes using this technique to traditional approaches are required to validate adenosine’s safety and efficacy in this high-risk setting. 

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Ref: https://www.tandfonline.com/doi/full/10.1080/02688697.2020.1817852