High Dose Magnesium Infusions Are Not Associated with Increased Pressor Requirements after Carotid Endarterectomy

Chiu, Camay; Heyer, Éric; Rampersad, Anita; Zurica, Joseph; Ornstein, Eugene; Sahlein, Daniel; Sciacca, Robert R.; Connolly, E. Sander

doi:10.1227/01.neu.0000190662.71046.66

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…151 The same group showed that the dose of MgSO 4 did not influence the requirement, duration, or amount of postoperative pressor support. 152 However, a truly neuroprotective effect of magnesium during carotid endarterectomy is difficult to claim because potential confounders such as residual effects of an-esthetics cannot be completely ruled out considering an observation period of only 24 h after surgery in that study.…”

Section: Experimental Datamentioning

confidence: 91%

Magnesium—Essentials for Anesthesiologists

et al. 2011

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Magnesium plays a fundamental role in many cellular functions, and thus there is increasing interest in its role in clinical medicine. Although numerous experimental studies indicate positive effects of magnesium in a variety of disease states, large clinical trials often give conflicting results. However, there is clear evidence for magnesium to benefit patients with eclampsia or torsades de pointes arrhythmias. In addition, magnesium seems to have antinociceptive and anesthetic as well as neuroprotective effects, yet well-designed large clinical trials are required to determine its actual efficacy in pain management or in the state of stroke or subarachnoid hemorrhage. The current review aims to provide an overview of current knowledge and available evidence with respect to physiologic aspects of magnesium and proposed indications and recommendations for its use in the clinical setting.

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Section: Experimental Datamentioning

confidence: 91%

Magnesium—Essentials for Anesthesiologists

et al. 2011

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“…A preliminary prospective dose escalation study in 80 patients undergoing elective carotid endarterectomy established that Mg and placebo groups had statistically significant different serum levels of Mg ( p < 0.01) and no significant difference in adverse events ( p = 0.66) ( 46 ). The neuroprotective effect of Mg in carotid endarterectomy was evaluated in a randomized, double-blinded, placebo-controlled study of 108 patients.…”

Section: Clinical Trials Of Magnesium Sulfate In Neurovascular Diseasmentioning

confidence: 99%

Magnesium: Potential Roles in Neurovascular Disease

et al. 2014

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Objective: Magnesium therapy has been studied extensively in pre-clinical and clinical trials in multiple organ systems. Cerebrovascular diseases may benefit from its neuroprotective properties. This review summarizes current studies of magnesium in a wide range of neurovascular diseases.Methods: We searched relevant terms in the National Library of Medicine PubMed database and selected research including basic science, translational reports, meta-analyses, and clinical studies.Results: Studies examining magnesium administration in ischemic stroke have failed to show any benefit in clinical outcome. Data on magnesium for intracerebral hemorrhage (ICH) are limited. Preliminary investigations in subarachnoid hemorrhage (SAH) were promising, but definitive studies did not reveal differences in clinical outcome between magnesium and placebo-treated groups. Studies examining magnesium administration in global ischemia following cardiac arrest suggest a trend toward improved clinical outcome. The strongest evidence for clinically relevant neuroprotection following magnesium administration derives from studies of pre-term infants and patients undergoing cardiac bypass and carotid endarterectomy procedures. Magnesium was found to have an excellent safety profile across all investigations.Conclusion: Magnesium is easy to administer and possesses a favorable safety profile. Its utility as a neuroprotectant in cardiac surgery, carotid endarterectomy, and pre-term infant hypoxia remain promising. Value as a therapeutic agent in ischemic stroke, ICH, and SAH is unclear and appears to be limited by late administration. Ongoing clinical trials assessing magnesium administration in the first hours following symptom onset may help clarify the role of magnesium therapy in these disease processes.

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