Adenosine-induced cardiac arrest and EEG changes in patients with thoracic aorta endovascular repair.
BACKGROUND
We studied haemodynamic and metabolic variables, and cerebral function after cardiac arrest induced by high dose of adenosine in patients undergoing thoracic aorta endovascular repair.


METHODS
Arterial blood pressure, blood gas values and EEG were recorded continuously in 15 patients undergoing anaesthesia (isoflurane) for endovascular thoracic aorta repair. Cardiac arrest was induced by different doses of adenosine (Adrekar, Sanofi-Synthelabo, Berlin, Germany; 0.4-1.8 mg kg(-1) body weight). Serum concentrations of neurone-specific enolase (NSE) were determined before and after stent graft implantation. Neurological function was assessed before and after surgery.


RESULTS
After adenosine, the heart beat stopped immediately for 18-58 s in close relation to the adenosine dose. EEG power was significantly reduced to -57%, but reached normal values within 5 min after cardiac arrest. In particular, the fast alpha- and beta-EEG-frequencies sensitively reflected patients' EEG activity during the procedure. No intraoperative increases in NSE concentrations, and no neurological dysfunctions after surgery, were observed.


CONCLUSIONS
After adenosine-induced cardiac arrest, changes in haemodynamic variables and EEG power spectra reversed completely within 1 and 5 min, respectively, without persistent brain dysfunction after stent graft implantation.
Plaschke
K
K
Clinic of Anaesthesiology, University of Heidelberg, Germany. konstanze.plaschke@med.uni-heidelberg.de
Böckler
D
D
Boeckler
D
D
Schumacher
H
H
Martin
E
E
Bardenheuer
H J
HJ
D000241:Adenosine / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D002245:Carbon Dioxide / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D015607:Stents; D014665:Vasodilator Agents / Q000494:pharmacology*
D014665:Vasodilator Agents; D002245:Carbon Dioxide; D000241:Adenosine; D010100:Oxygen