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CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2022; 09(03): 168-176
DOI: 10.1055/s-0042-1750692
Original Article

Effects of Magnesium Sulfate on Intraoperative Blood Loss and Anesthetic Requirement in Meningioma Patients Undergoing Craniotomy with Tumor Removal: A Prospective Randomized Study

Thanawut Jitsinthunun
1   Department of Anaesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
,
Manee Raksakietisak 
1   Department of Anaesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
,
Chanitda Pantubtim
1   Department of Anaesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
,
Porntip Mahatnirunkul
1   Department of Anaesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
› Author Affiliations Funding This study is supported by grant funds from Siriraj Research Development Fund, Faculty of Medicine, Siriraj Hospital, Mahidol University (R016131045). The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.
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Abstract

Background Meningioma brain tumor is associated with significant blood loss. Magnesium (Mg), a calcium blocker, can facilitate blood pressure control during surgery. This study aimed to evaluate effects of magnesium on blood loss, anesthetic requirement, and its neuroprotective effect in meningioma patients undergoing craniotomy.

Methods Eighty patients aged between 18 and 70, American Society of Anesthesiologists physical status I and II, diagnosed with meningioma and scheduled for craniotomy tumor removal were randomized into two groups. Group M (Mg) received intravenous magnesium sulfate 40 mg/kg over 30 minutes initiated at skin incision and followed by continuous infusion of 10 mg/kg/h until dura closure. Group N (NSS) received 0.9% NaCl as placebo. Anesthesiologists in charge, surgeons, and patients were all blinded. The assessed outcomes were perioperative blood loss, anesthetic requirement, and pre- and postoperative neurocognitive functions assessed by Montreal Cognitive Assessment (MoCA).

Results Thirty-eight patients in each group were analyzed. In group M, the intraoperative blood losses were 500 (70, 2300) mL, and 510 (100, 1600) mL in group N (p = 0.315). Patients who received blood within 24 hours were 39.5% in group M and 47.4% in group N (p = 0.644). No differences were observed in anesthetic requirement, intraoperative mean arterial pressure, hypotensive episodes, and vasopressor usages. There were no significant differences in postoperative MoCA score. Magnesium levels did not exceed acceptable levels.

Conclusions Magnesium administration in meningioma patients had no significant effects on blood loss, anesthetic requirement, and postoperative cognitive function.

Keywords

blood loss - craniotomy - magnesium - meningioma


Publication History

Article published online:
20 July 2022

© 2022. Indian Society of Neuroanaesthesiology and Critical Care. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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