Abstract

Background: Derived from opium poppy (Papaver somniferous), papaverine is a non-analgesic opioid vasodilator employed in the treatment of vasospasm and impotency. Cerebral vasospasm, a major contributor to unfavorable outcomes in subarachnoid hemorrhage resulting from intracranial aneurysm rupture, prompted this investigation. The study aims to compare the incidence of ischemia in patients subjected to perioperative papaverine irrigation within the subarachnoid space during aneurysm surgery with those who did not receive preoperative papaverine treatment. Materials and Methods: Conducted at Madras Medical College, Chennai, in 2022, this study involved 49 patients. Postoperatively, patients were closely monitored for cerebral ischemia, and evaluated through clinical and radiological indicators. Results: Thirty-five patients with anterior communicating artery (ACOM) aneurysms and fourteen patients with middle cerebral artery (MCA) aneurysms were assessed for cerebral ischemia post-aneurysm clipping. The study compared outcomes between patients who underwent topical papaverine irrigation in the subarachnoid space and those who did not receive papaverine irrigation. Conclusion: Papaverine irrigation during aneurysm surgery within the subarachnoid space effectively mitigates vasospasm and cerebral ischemia, consequently reducing morbidity and mortality associated with aneurysm surgery.

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