{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:17:13Z","timestamp":1783516633505,"version":"3.55.0"},"reference-count":9,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":166,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Adenosine\u2010induced transient cardiac asystole is used in intracranial aneurysm surgery to achieve flow arrest and facilitate clipping, particularly when proximal control is unavailable. Inadequate asystole duration or refractory responses can limit its utility, especially during intra\u2010operative rupture. We describe a 48\u2010year\u2010old man with subarachnoid haemorrhage from a ruptured left supraclinoid internal carotid artery aneurysm and an unruptured right supraclinoid aneurysm. Both were approached via single left craniotomy. After uneventful clipping of the left aneurysm, clipping of the right aneurysm was attempted with 12\u2009mg and 18\u2009mg of adenosine, resulting in brief (8 s and 11\u2009s, respectively) periods of asystole. During the rupture, carotid compression combined with 24\u2009mg adenosine achieved asystole lasting 30\u2009s with return of electrical activity only upon release of carotid compression, enabling safe clipping within 25\u2009s of asystole onset. Hypotension persisted for an additional 60\u2009s, after which the patient fully recovered. Combining mechanical carotid compression with adenosine synergistically prolonged asystole beyond that expected from adenosine alone, likely via enhanced parasympathetic effects on sino\u2010atrial and atrioventricular nodes.<\/jats:p>","DOI":"10.1002\/anr3.70073","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T08:39:43Z","timestamp":1781599183000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Synergistic effect of carotid compression and adenosine on cardiac rhythm to prolong flow arrest during intracranial aneurysm surgery"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3795-8469","authenticated-orcid":false,"given":"D. G.","family":"Palaksha","sequence":"first","affiliation":[{"name":"Department of Neuroanaesthesia and Neurocritical Care National Institute of Mental Health and Neurosciences  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Dhanalakshmi","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesia and Neurocritical Care National Institute of Mental Health and Neurosciences  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Deora","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery National Institute of Mental Health and Neurosciences  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery National Institute of Mental Health and Neurosciences  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1999.91.4.0687"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.14797\/mdcj-10-4-220"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9051366"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANA.0000000000001046"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.25259\/SNI_79_2020"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANA.0b013e3181ef2b11"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-015-2581-7"},{"key":"e_1_2_5_9_1","article-title":"Inadequate adenosine\u2010induced flow arrest during intraoperative basilar aneurysm surgery","volume":"15","author":"Pereira A","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/152660280000700406"}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.70073","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/anr3.70073","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.70073","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T12:38:49Z","timestamp":1783514329000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.70073"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/anr3.70073"],"URL":"https:\/\/doi.org\/10.1002\/anr3.70073","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"value":"2637-3726","type":"print"},{"value":"2637-3726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-06-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70073"}}