Effect of intrathecal magnesium sulfate solution injection via a microcatheter in the cisterna magna on cerebral vasospasm in the canine subarachnoid haemorrhage model

Mori, Kentaro; Yamamoto, Takuji; Miyazaki, Masahiro; Hara, Yasukazu; Aiko, Yasuhisa; Koike, Nobuhiro; Sakamoto, Shinsuke; Nakao, Yasuaki; Esaki, Takanori

doi:10.3109/02688697.2011.591948

Cited by 12 publications

(11 citation statements)

References 20 publications

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“…[5] Neuroprotective effects of magnesium sulfate and its effect on cerebral blood flow[67] can be advantageous during controlled hypotension. However, there are the potential risks of magnesium such as, potentiation of opioids and neuromuscular blockers leading to delayed emergence.…”

Section: Discussionmentioning

confidence: 99%

Comparison of quality of the surgical field after controlled hypotension using esmolol and magnesium sulfate during endoscopic sinus surgery

Jangra

Malhotra

Gupta

et al. 2016

J Anaesthesiol Clin Pharmacol

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Background and Aims:Most vital aspect of Endoscopic Sinus Surgery (ESS) is an optimal visibility in the surgical field. This invariably requires controlled hypotension to facilitate surgical dissection and to decrease operative time. We used esmolol and magnesium sulfate to achieve controlled hypotension and assessed the quality of the surgical field in ESS.Material and Methods:A total of 30 patients undergoing ESS, were enrolled in three parallel groups of 10 patients each in a prospective randomized double-blind study. “Magnesium Sulfate group” received magnesium sulfate 40 mg/kg intravenously (i.v.) as a bolus over 10 min before induction of anesthesia, followed by 15-30 mg/kg/h through infusion. “Esmolol group” received 0.5 mg/kg i.v. bolus over 10 min after induction followed by 150-300 μg/kg/min infusion and “control group” received normal saline in same volume schedule. The primary aim was to assess the quality of surgical field, using Fromme scale. Category Scale values of all the three groups were compared using Kruskal-Wallis analysis of variance (ANOVA) test. Hemodynamic data was compared using ANOVA test.Results:Quality of the surgical field was better in both magnesium sulfate and esmolol groups as compared to the control group. Durations of anesthesia and surgery were significantly lower in esmolol group as compared to the control group. Blood loss was comparable in all the three groups.Conclusion:Quality of the surgical field was better in esmolol and magnesium sulfate groups as compared to control group. Duration of surgery was significantly less in esmolol group as compared to other two groups.

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Section: Discussionmentioning

confidence: 99%

Comparison of quality of the surgical field after controlled hypotension using esmolol and magnesium sulfate during endoscopic sinus surgery

Jangra

Malhotra

Gupta

et al. 2016

J Anaesthesiol Clin Pharmacol

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“…In experimental settings, magnesium treatment preserves the ischemia-induced reduction in S-100 proteins, possibly by restoration of blood brain permeability during hypoxia [28] . Additionally, Mori et al [29] have described neuro-protective effects following intrathecal infusion of magnesium in a rat model of subarachnoid hemorrhage. Neuroprotective effects of magnesium are considered advantageous during controlled hypotension.…”

Section: Discussionmentioning

confidence: 99%

Comparative induction of controlled circulation by magnesium and remifentanil in spine surgery

Ghodraty

Homaee

Farazmehr

et al. 2014

WJO

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of blood loss, urine output, fluid intake and surgeon' s satisfaction were recorded. Data was analyzed with SPSS version 13.0 and P values less than 0.05 were considered significant. RESULTS:Twenty patients in the MGS group and 19 patients in the REM group were studied. There was no difference between the two groups in the hemodynamic variables, blood loss, urine output, fluid requirement and surgeon's satisfaction for exposure. The target MAP was achieved in 75% of Mg and 58% of remifentanil groups. Although a higher number of patients in the REM group required nitroglycerin (42.1%) to reach the target MAP than those in the MGS group (25%), this difference was not statistically significant (P = 0.32). CONCLUSION:Our findings showed that in patients undergoing lumbar PSF surgery, remifentanil and MGS have a similar hypotensive effect and comparable amount of blood loss without any significant adverse effects.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Controlled hypotension; Magnesium sulfate; Remifentanil; Spine surgery; Blood loss Core tip: We conducted a relatively small sized prospective randomized clinical trial comparing intravenous infusion of remifentanil with magnesium in controlling blood pressure during posterior spine fusion in order to decrease the intraoperative blood loss. Our experiments showed no difference between the two administered regimens in reducing mean arterial blood pressure and intraoperative blood loss, and satisfaction of the operating surgeons. METHODS:In this randomized clinical trial, 40 patients with the American Society of Anesthesiologists Ⅰ and Ⅱ physical status undergoing lumbar PSF were randomized to receive remifentanil (REM) 0.15 μg/kg or MGS 50 mg/kg for controlled hypotension. The administering anesthesiologist was blinded to the medication. Continuous infusion was maintained at a fixed volume rate to deliver precalculated doses of either study drugs. All other aspects of anesthesia and surgery were similar in the two groups. The target mean arterial pressure (MAP) range used in this study was 60-70 mmHg. In the course of surgery, the hemodynamic variables, volume BRIEF ARTICLE

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“…The various mechanisms of action of Mg 2+ include reduction of excitatory amino acid release, blockage of the NMDA-glutamate receptor and voltage-dependent calcium channels, inhibition of platelet aggregation, inhibition of endothelin-1 synthesis, vasodilation through the release of endothelial nitric oxide (NO), and increased synthesis of prostacyclins (Berthon et al, 2003; Nadler et al, 1987; van den Bergh et al, 2004; Yang et al, 2000). Both animal studies and pilot clinical trials using magnesium sulfate have reported trends toward improved outcomes (Mori et al, 2011, 2012). In the Field Administration of Stroke Therapy–Magnesium (FAST-MAG) pilot trial, prehospital administration of magnesium is feasible and safe in acute ischemia stroke patients (Saver et al, 2004).…”

Section: 3 Neurobiological Response After Sahmentioning

confidence: 99%

Controversies and evolving new mechanisms in subarachnoid hemorrhage

Chen

Feng

Sherchan

et al. 2014

Progress in Neurobiology

317

264

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Despite decades of study, subarachnoid hemorrhage (SAH) continues to be a serious and significant health problem in the United States and worldwide. The mechanisms contributing to brain injury after SAH remain unclear. Traditionally, most in vivo research has heavily emphasized the basic mechanisms of SAH over the pathophysiological or morphological changes of delayed cerebral vasospasm after SAH. Unfortunately, the results of clinical trials based on this premise have mostly been disappointing, implicating some other pathophysiological factors, independent of vasospasm, as contributors to poor clinical outcomes. Delayed cerebral vasospasm is no longer the only culprit. In this review, we summarize recent data from both experimental and clinical studies of SAH and discuss the vast array of physiological dysfunctions following SAH that ultimately lead to cell death. Based on the progress in neurobiological understanding of SAH, the terms “early brain injury” and “delayed brain injury” are used according to the temporal progression of SAH-induced brain injury. Additionally, a new concept of the vasculo-neuronal-glia triad model for SAH study is highlighted and presents the challenges and opportunities of this model for future SAH applications.

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Effect of intrathecal magnesium sulfate solution injection via a microcatheter in the cisterna magna on cerebral vasospasm in the canine subarachnoid haemorrhage model

Abstract: Intracisternal MgSO(4) therapy using a microcatheter from the lumbar spine may be effective against vasospasm in the clinical setting of endovascular treatment of ruptured aneurysm.

Cited by 12 publications

References 20 publications

Comparison of quality of the surgical field after controlled hypotension using esmolol and magnesium sulfate during endoscopic sinus surgery

Comparison of quality of the surgical field after controlled hypotension using esmolol and magnesium sulfate during endoscopic sinus surgery

Comparative induction of controlled circulation by magnesium and remifentanil in spine surgery

Controversies and evolving new mechanisms in subarachnoid hemorrhage

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