Magnesium sulfate: Role as possible attenuating factor in vasospasm morbidity

Daniel Monte Serrat Prevedello, Joacir Graciolli Cordeiro, Andrei Leite De Morais, Nestor Saucedo Saucedo, Iara B. Chen, João Cândido Araújo

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Background: Among the many complications of SAH, one of the most important is vasospasm. Several treatment alternatives have been proposed for this condition, with far-from-ideal results being obtained. Magnesium sulfate recently returned to the scene (with still unproven benefit) as an adjuvant in the treatment of vasospasm. Methods: Seventy-two patients diagnosed with SAH by aneurysm rupture were submitted to microsurgery craniotomy and subdivided in 2 groups. Group 1, formed by 48 patients, received prophylactic hypervolemic and hemodilution therapy in addition to nimodipine. Group 2, composed of 24 patients, received the same treatment of group 1 with the addition of magnesium sulfate in continuous infusion from 120 to 150 mg a day, keeping serum magnesium levels close to double normal values. Results: Age was 49 ± 12.6 years. Ratio of female to male was 3.16:1. Most patients were admitted in a Hunt-Hess grade 2 (46.4%) and Fisher grade 3 (52.8%). Anterior communicating artery aneurysms were the most common in location (38.8%). Both groups were compared, and there was no statistical difference related to age, sex, and Glasgow, Fisher, or Hunt-Hess admission grades. No statistical difference in vasospasm incidence was found between the two groups. However, in group 1, vasospasm was correlated with a longer hospitalization time (P = .0003), different from group 2, in which patients with vasospasm receiving magnesium sulfate required less hospitalization time. Conclusion: Magnesium did not seem to interfere in vasospasm frequency but apparently acted favorably in decreasing morbidity and length of hospital stay.

Original languageEnglish (US)
Pages (from-to)S14-S20
JournalSurgical neurology
Volume65
Issue numberSUPPL. 1
DOIs
StatePublished - Feb 2006
Externally publishedYes

Keywords

  • Intracranial aneurysm
  • Magnesium sulfate
  • Subarachnoid hemorrhage
  • Vasospasm

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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