Role of Magnesium Sulfate in Preventing Vasospasm and Maintaining Hemodynamic Stability in Patients Undergoing Endovascular Coiling for Brain Aneurysm

S. Sheybani, H. Baharvahdat, M. Najafi, M. Alipour, A. Bameshki, Mohammad Hosein Eshaghi Ghalibaf, Shadi Sheibani
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Abstract

Introduction: Themaintenance of hemodynamic stability in brain aneurysm surgery has paramount clinical significance in order to prevent vasospasm in the patients with aneurysmal subarachnoid hemorrhage. Regarding this, the present study was conducted to assess the role of magnesium sulfate in preventing vasospasm and maintaining hemodynamic stability during endovascular coiling procedure for brain aneurysm. Materials and Methods: This double-blind clinical trial was conducted on 60 patients who were candidates for undergoing endovascular coiling for brain aneurysm. The patients were subjected to angiography through femoral artery catheterization. Then, they were randomly assigned into two treatment groups of case receiving magnesium sulfate and control administered normal saline. The vasospasm and hemodynamic status were measured and recorded during and following the surgery. Results: According to the results, no significant difference was observed between the two groups in terms of heart rate (p=0.98) and mean arterial pressure =p) 0.89(  one hour post-surgery. Furthermore, there was no statistical difference between the two groups regarding the use of nimodipine ( p=0.11). Nevertheless, the frequency of vasospasm was significantly lower in the patients receiving magnesium sulfate, during surgery (p=0.037) and after surgery (p=0.02), compared to those administered normal saline. Conclusion: As the findings indicated, magnesium sulfate could lower the incidence of vasospasm during and following the endovascular coiling procedure for brain aneurysm. Moreover, it resulted in no adverse effects on the hemodynamic status of the patients.
硫酸镁在脑动脉瘤血管内盘绕术中预防血管痉挛和维持血流动力学稳定中的作用
摘要维持脑动脉瘤手术中血流动力学的稳定性对预防动脉瘤性蛛网膜下腔出血患者血管痉挛具有重要的临床意义。因此,本研究旨在评估硫酸镁在脑动脉瘤血管内盘绕术中预防血管痉挛和维持血流动力学稳定的作用。材料与方法:本双盲临床试验对60例脑动脉瘤行血管内盘绕术的候选患者进行研究。患者通过股动脉导管行血管造影。然后,他们被随机分为两个治疗组,病例给予硫酸镁,对照组给予生理盐水。测量并记录术中及术后血管痉挛及血流动力学状态。结果:两组患者术后1 h心率(p=0.98)、平均动脉压(p) 0.89,差异无统计学意义。两组患者尼莫地平的使用差异无统计学意义(p=0.11)。然而,与给予生理盐水的患者相比,接受硫酸镁治疗的患者在手术中(p=0.037)和手术后(p=0.02)血管痉挛的频率明显降低。结论:硫酸镁可降低脑动脉瘤血管内盘绕术中及术后血管痉挛的发生率。此外,对患者血流动力学状态无不良影响。
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