Cardiac Emergencies in Neurosurgical Patients

Table 6

Drug-induced cardiac emergencies in neurosurgery.

Author	Patient	Procedure	Cardiac rhythm	Cause	Management	Outcome
Bharati et al. [47]	5 patients [51–76 y, ♂ = 5]	Lumbar laminectomy; ( = 1); cervical discectomy ( = 2); craniotomy ( = 3)	VT ( = 1); asystole ( = 3); bradycardia; ( = 1); PEA; ( = 2)	Dexmedetomidine	CPR ( = 5), dopamine infusion ( = 3)	No neurological deficits
Baltaci et al. [48]	50 y ♂	Pterional craniotomy (ICA aneurysm)	Bradycardia, sinus arrest (60 min)	Locally applied papaverine	Atropine, CPR	Death
Braz et al. [49]	2/18 (cardiac arrest cases)
	27 y ♀	Resection (vertebral column metastases)	Not specified	Asystole after IV metoprolol	CPR	Death
	37 y ♂	Cerebral abscess drainage	Not specified	Asystole after propofol	CPR	No neurological deficits
Miyahara et al. [50]	87 y ♂	Cervical laminectomy	VF (5 min)	Hyperkalemia	CPR	No neurological sequelae
Berry et al. [51]	49 y ♀	Craniotomy (aneurysm clipping)	Asystole (5 min)	Phenytoin overdose	CPR; epinephrine, calcium chloride, atropine	Drowsiness to postoperative day three
Lin et al. [52]	59 y ♀	Craniotomy (metastatic brain tumor)	Hypotension, bradycardia, complete AV blockade, asystole	Ephedrine with phenytoin infusion	Epinephrine	Good

♀ = female gender; ♂ = male gender; ICA = internal carotid artery; VT = ventricular tachycardia; VF = ventricular fibrillation; PEA = pulseless electrical activity; CPR = cardiopulmonary resuscitation including chest compressions; no neurological deficits = postoperative deficits not mentioned.