Abstract:
BACKGROUND:In patients with subarachnoid hemorrhage (SAH), vasospasm remains one of the major complications. The application of intravenous magnesium sulfate (MgSO4) has been under discussion to prevent cerebral ischemia. Our aim was to examine the impact of early MgSO4 administration on local cerebral microcirculation during microsurgical clipping of SAH-related aneurysms. METHODS:The non-invasive laser-Doppler spectrophotometry system "Oxygen-to-See (O2C)" was used in 14 consecutive patients (11 female, 3 male, median age 56.5±9.7 yrs) with aneurysmatic SAH. A subdural probe measured capillary venous oxygenation (SO2), relative hemoglobin content (rHb), blood cell velocity (velo) and blood flow (flow) in 7 mm tissue depth. Data samples were recorded as baseline immediately before intraoperative application of MgSO4 10% 50 mg/kg body weight and 10 min thereafter. The continuous MgSO4 infusion rate depended on blood pressure (mean arterial pressure > 60-65 mmHg) and lasted a maximum of 60 min. RESULTS:MgSO4 was administered 2.8 (min. 1.6, max. 15.5) hours after onset of symptoms. Median flow increased significantly by 20.8% (5-68%, p = 0.001). Velo increased 4.9% (1-17%), rHb decreased 1.5% (3-34%) and SO2 decreased 9.4% (8-38%) by trend compared to the baseline values. FiO2 correlated positively with velo (rs = 0.712, p = 0.004), whereas arterial HCO3 correlated negatively with SO2 (rs = -0.599, p = 0.024). Of 14 patients, 2 had symptomatic vasospasm. CONCLUSIONS:Our data suggest an increased cerebral blood flow after early intraoperative administration of MgSO4 in patients with SAH. Using a non-invasive laser-Doppler spectrophotometry system, this technique is feasible for continuous real-time monitoring of cerebral microcirculation. TRIAL REGISTRATION:DRKS (German Clinical Trial Registry), DRKS00013047 , retrospectively registered on September 21st, 2017.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Sommer B,Weidinger CS,Wolf D,Buchfelder M,Schmitt Hdoi
10.1186/s12871-017-0435-ysubject
Has Abstractpub_date
2017-10-17 00:00:00pages
143issue
1issn
1471-2253pii
10.1186/s12871-017-0435-yjournal_volume
17pub_type
杂志文章abstract:BACKGROUND:Lumbar puncture for spinal or epidural anesthesia is commonly performed by palpating bony landmarks, but identification of the desired intervertebral level is often inaccurate. It is unclear whether such inaccuracy is related to patient factors, such as body mass index and degree of lumbar flexion. We hypoth...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-15-9
更新日期:2015-01-21 00:00:00
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abstract:BACKGROUND:Sodium nitroprusside (SNP) is a potent vasodilator that has been used to induce deliberate hypotension in children during surgery involving significant blood loss, including craniofacial and spinal fusion procedures. SNP metabolism liberates cyanide, which may cause interference with cellular energy metaboli...
journal_title:BMC anesthesiology
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更新日期:2017-04-27 00:00:00
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journal_title:BMC anesthesiology
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更新日期:2008-07-17 00:00:00
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journal_title:BMC anesthesiology
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abstract::An amendment to this paper has been published and can be accessed via the original article. ...
journal_title:BMC anesthesiology
pub_type: 已发布勘误
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更新日期:2014-12-03 00:00:00
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更新日期:2018-10-20 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章,随机对照试验
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更新日期:2018-12-19 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,评审
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