Anesthesia for neurosurgery requires balancing deep and effective anesthesia as well as postoperative analgesia versus the risks of delayed recovery and postoperative respiratory depression. This randomized placebo-controlled, double-blind study was designed to evaluate the effect of magnesium sulfate on the total anesthetic and analgesic consumption using the clinical parameters in addition to the effect on IONM reading.
Objectives: 1. Decrease anesthetic consumption 2. Decrease use of muscle relaxants 3. Decrease analgesic consumption 4. Excellent recovery Patients \& Methods: * 2 groups (total 50) Randomized Controlled Double Blind (RCDB) Study * Propofol + remifentanil + saline (Control = C group) * Propofol + remifentanil + Mgso4 (Magnesium = M group) * Adult Spine decompression and fixation After getting the Institutional Review Board (IRB) approval, This randomized controlled double blind study includes 2 groups of patients (each group 25) will be enrolled in the study. All patients undergo spine decompression and fixation surgery Induction: All patients in the study will receive iv fentanyl 2 mic/kg + propofol 2mg/kg and endotracheal intubation will be facilitated with rocuronium 0.60 mg/ kg. Then anesthesia will be maintained using total intravenous anesthesia with propofol (6-9 mg/kg/hr) + remifentanil (0.03-0.05 mic / kg/ min) Group 1 (C group) : Receive 10 mg/kg /hr 0.9% Normal Saline Group 2 (M group) : Receive 10 mg/kg/hr Magnesium Sulfate Monitoring: 1. IONM 2. train-of-four (TOF) 3. bispectral index (BIS) Measurements: 1. IO Anesthetic Consumption 2. IO Hemodynamics 3. somatosensory evoked potential (SSEP), motor evoked potential (MEP), TOF, BIS Readings 4. PO visual analogue scale (VAS) (24hours) 5. PO Morphine Consumption (24hours)
Study Type
OBSERVATIONAL
Enrollment
50
spine decompression and fixation
Anesthesia Department, Faculty of Medicine, King Khalid University Hospital, King Saud University
Riyadh, Saudi Arabia
IONM Reading
Reading the effect on the intraoperative neuromonitoring either motor or sensory evoked potential
Time frame: 1- baseline 2-during surgery 3-immediately after surgery
Blood Pressure
Systolic, Diastolic and Mean (mmHg)
Time frame: 1- baseline 2-during surgery 3-immediately after surgery 4- every one hour postoperative till 24 hours
Heart Rate
beats/min
Time frame: 1- baseline 2-during surgery 3-immediately after surgery 4- every one hour postoperative till 24 hours
Morphine Consumption
Total morphine consumed over 24 hours in mg
Time frame: Over 24 hours postoperative
Pain Score
11 Visual Analogue Scale (VAS) with 10 is the worst and 0 is the least
Time frame: Over 24 hours postoperative
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