Magnesium research : official organ of the International Society for the Development of Research on Magnesium
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Randomized Controlled Trial
Analysis of the effect of perioperative magnesium sulphate on minimal alveolar concentration of desflurane using bispectral index monitoring.
In this study we aimed to analyze the effect of perioperative magnesium sulphate (MgSO(4)) on minimal alveolar concentration (MAC) of desflurane using bispectral index (BIS) monitoring. ⋯ We concluded that perioperative MgSO(4) infusion may be used as an adjunct as it decreases MAC of desflurane and suppresses the hemodynamic response to intubation.
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Randomized Controlled Trial
Oral magnesium treatment in patients with neuropathic pain: a randomized clinical trial.
Studies in animals and in patients have suggested that magnesium (Mg), a physiological blocker of N-methyl-D-aspartate receptor, could have an antinociceptive effect in painful situations. This randomised, double-blind, controlled trial in two parallel groups aims at studying oral Mg effects in patients with neuropathic pain. ⋯ This clinical trial displays a large placebo response and could not demonstrate any significant difference in pain alleviation after a month of oral treatment between Mg and placebo in patients suffering from neuropathic pain. Frequency of pain paroxysms and emotional impact will be explored in future studies as they constitute major aspects of pain alleviation in chronic pain conditions.
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Changes in plasma matrix metalloproteinase 9 (MMP-9) concentrations and parallel changes in brain magnesium homeostasis have not been examined in cardiac surgery patients. The purpose of the present study was to analyse these relationships in patients undergoing coronary artery bypass surgery (CABG) with extracorporeal circulation (ECC). Additionally, the effect of volatile anaesthetics was considered. ⋯ 1. Cardiac surgery resulted in an increase in plasma MMP-9 concentrations. 2. This increase in MMP-9 was significantly greater in patients with PNPDs. 3. The plasma MMP-9 concentration was correlated with disorders of brain Mg homeostasis.
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Subarachnoid haemorrhage (SAH) caused by a ruptured aneurysm accounts for only 5% of strokes, but occurs at a fairly young age and carries a worse prognosis. Delayed cerebral ischaemia (DCI) is an important cause of death and dependence after aneurysmal subarachnoid haemorrhage. The current mainstay of preventing DCI is nimodipine and maintenance of normovolemia, but even with this strategy DCI occurs in a considerable proportion of patients. ⋯ In a subgroup analysis in the Cochrane review of all randomized clinical trials of calcium antagonists in SAH, magnesium reduced the occurrence of DCI and that of poor outcome. Magnesium is a promising agent to prevent the occurrence of secondary ischemia and to improve outcome in patients with SAH. Currently two large phase Il trials are being conducted that will hopefully provide definite evidence whether magnesium treatment is beneficial in SAH patients.
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Randomized Controlled Trial Multicenter Study
The effect of hypermagnesemic treatment on cerebrospinal fluid magnesium level in patients with aneurysmal subarachnoid hemorrhage.
Preliminary evidence has suggested that magnesium sulfate infusion reduces delayed ischemic neurological deficit and improves clinical outcome after aneurysmal subarachnoid hemorrhage. However, little is known about its site of action in vivo. We studied 22 aneurysmal subarachnoid hemorrhage patients with or without magnesium sulfate infusion for 10-14 days. ⋯ We found that the magnesium sulfate infusion bought an 11% to 21% increase in cerebrospinal fluid magnesium. The elevation of cerebrospinal fluid magnesium was sustained for at least nine days. Whether this mild elevation in cerebrospinal fluid magnesium level was adequate for neuroprotection awaits the results of ongoing clinical trials.