Cerebrospinal fluid passage of intravenous magnesium sulfate in neurosurgical patients
Cerebrospinal fluid passage of intravenous magnesium sulfate in neurosurgical patients
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DOI：
10.1097/00008506-199710000-00006
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发表时间：
1997-10-01
影响因子：
3.7
通讯作者：
Tassonyi, E
中科院分区：
文献类型：
--
作者：
FuchsBuder, T;Tramer, MR;Tassonyi, E
越来越多的证据表明硫酸镁（MgSO 4）具有神经保护潜力。在神经外科患者中，关于MgSO 4进入脑脊液（CSF）的信息有限。然而，关于镁的神经保护特性的临床相关性，需要关于其CSF通过的定量数据。本研究旨在评估镁在神经外科患者脑脊液中通过的量和时间过程。为此，纳入了20例接受神经外科全身麻醉并需要CSF引流的患者。患者接受静脉注射，推注60 mg/kg MgSO 4。在MgSO输注结束后30、90和240分钟测量血浆和CSF镁浓度的增加。将这些值与MgSO 4输注开始前的基线水平进行比较。因此，每名患者均作为其自身对照。数值表示为平均值+/- SD。如下测量血浆镁水平：基线，0.74 +/- 0.12 mM;在30 min时，1.24 +/- 0.1 mM（p < 0.01）;在90 min时，0.95 +/- 0.15 mM（ip < 0.01），以及在240 min时，0.82 +/-0.14 mM（p < 0.05）。CSF镁水平测量如下：基线，0.95 +/- 0.11 mM; 30 min时，1.00 +/- 0.15 mM（NS）I，90 min时，1.10 +/-：0.17 mM（p < 0.01）; 240 min时，1.13 +/- 0.19 mM（p < 0.001）。我们得出结论，60 mg/kg的MgSO 4推注至少在90分钟后导致CSF中镁浓度显著增加。此外，血浆和CSF镁浓度的增加不是平行的。因此，血浆镁浓度不能用于预测CSF浓度的变化。
Increasing evidence suggests a neuroprotective potential of magnesium sulfate (MgSO4). Only limited information about the passage of MgSO4 to the cerebrospinal fluid (CSF) is available in neurosurgical patients. However, with regard to the clinical relevance of magnesium's neuroprotective properties, quantitative data about its CSF passage are needed. The present study aims to assess the amount and the time course of magnesium's CSF passage in neurosurgical patients. To this end,20 patients undergoing general anesthesia for neurosurgery and needing CSF drainage were included. Patients received an i.v., bolus of 60 mg/kg MgSO4. The increase in plasma and CSF magnesium concentration were measured 30, 90, and 240 min after the end of the MgSO infusion. These values were compared with the baseline levels taken before the start of the MgSO4 infusion. Thus, each patient served as his or her own control. Values are expressed as means +/- SD. The plasma magnesium levels were measured as follows: baseline, 0.74 +/- 0.12 mM; at 30 min, 1.24 +/- 0.1 mM (p < 0.01); at 90 min, 0.95 +/- 0.15 mM ip < 0.01), and at 240 min, 0.82 +/-:0.14 mM (p < 0.05). The CSF magnesium levels were measured as follows: baseline, 0.95 +/- 0.11 mM; at 30 min, 1.00 +/- 0.15 mM(NS)I at 90 min,1.10 +/-: 0.17 mM (p < 0.01); and at 240 min, 1.13 +/- 0.19 mM (p < 0.001). We concluded that a bolus of 60 mg/kg of MgSO4 leads at least after 90 min to a significant increase in the CSF: magnesium concentration. Moreover, the increase in plasma and CSF magnesium concentration is not parallel. Thus, plasma magnesium concentration cannot be used to predict the changes in CSF concentrations.