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result(s) for
"Magnesium sulfate"
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Prehospital Use of Magnesium Sulfate as Neuroprotection in Acute Stroke
by
Starkman, Sidney
,
Liebeskind, David S
,
Pratt, Franklin D
in
Acute Disease
,
Aged
,
Brain Ischemia - complications
2015
In this randomized trial involving patients with acute stroke, prehospital administration of magnesium sulfate by paramedics within 2 hours after the onset of stroke symptoms (within 1 hour for 74% of patients) did not improve neurologic outcomes.
Stroke is the second leading cause of death and a leading cause of adult disability worldwide. Unfortunately, currently available therapies for acute ischemic stroke, which are all reperfusion-based, are only moderately effective.
1
,
2
Treatment with tissue plasminogen activator (t-PA), the only pharmacologic treatment approved by a regulatory agency for the treatment of acute ischemic stroke, results in early reperfusion in less than half of treated patients, can be started only after neuroimaging has ruled out intracerebral hemorrhage, and is used in only 2 to 7% of patients with acute ischemic stroke in the United States.
1
Mechanical thrombectomy devices improve patient . . .
Journal Article
Randomized trial to compare acceptability of magnesium sulphate administration for preeclampsia and eclampsia: Springfusor pump versus standard of care
2024
In low-resource settings, magnesium sulphate (MgSO4) for preeclampsia is administered majorly through an injection into the gluteal muscles 4-hourly for 24 hours. The repeated injections are very painful and may lead to infection, abscess formation, and reduced compliance.
To determine the acceptability of Springfusor® pump for the administration of Magnesium Sulphate in preeclampsia and eclampsia.
Randomized Open Label Clinical Trial.
The study was conducted at Kawempe National Referral Hospital. Eligible women had a systolic blood pressure of ≥140mmHg and or diastolic blood pressure >90mmHg, proteinuria ≥+1, and the physician's decision to start on MgSO4. Four-hundred-ninety-six participants were randomized to a Springfusor® pump group (n = 248) or control (standard of care) (n = 248) administration of MgSO4. Intervention group had a loading dose (4gm of 50% MgSO4 intravenously over 20 minutes) and maintenance therapy (1gm of 50% MgSO4 intravenously per hour for 24 hours) administered using the Springfusor®. The standard of care (SOC) group received a loading dose of 4gm of 20% MgSO4 IV over 15-20 minutes, followed by 10gm of 50% MgSO4 intramuscular (5gm in each buttock) and a maintenance dose of 5gm of 50% MgSO4 was administered IM every 4 hours for 24 hours. Both arms received the rest of the care for preeclampsia/eclampsia as per the hospital guidelines. Acceptability of the method of administration was assessed using a Likert scale (1-5; 1 and 2: acceptable and 3-5: unacceptable). Pain at the site of MgSO4 administration was assessed using a Visual Analogue Scale 1-7, (1 minimal pain and 7 worst pain). Comparisons were assessed with the Chi-square test, Mann Whitney-Wilcoxon test, and Students' t-test.
Intervention arm; was more acceptable than the standard of care arm, (95.3% vs70.3%; p<0.001), had a lower median pain score, (2(CI: 2-2), vs 4(CI: 4-5) p<0.001), and fewer side effects. Maternal mortality was comparable between groups (0.8% in the intervention arm vs 1.2% in the IM arm).
Trial No PACTR201712002887266 (https://pactr.samrc.ac.za/).
Journal Article
A Randomized, Controlled Trial of Magnesium Sulfate for the Prevention of Cerebral Palsy
by
Wapner, Ronald J
,
Thorp, John M
,
Spong, Catherine Y
in
Adult
,
Biological and medical sciences
,
Cerebral palsy
2008
In this multicenter, placebo-controlled, randomized trial of intravenous magnesium sulfate in women at imminent risk for delivery between 24 and 31 weeks of gestation, magnesium sulfate did not significantly reduce the primary composite outcome of moderate or severe cerebral palsy or death. However, it did result in a reduced rate of cerebral palsy among survivors (a prespecified secondary outcome), which may suggest the possibility of benefit.
In women at imminent risk for delivery between 24 and 31 weeks of gestation, magnesium sulfate did not significantly reduce the primary composite outcome of moderate or severe cerebral palsy or death. However, it did result in a reduced rate of cerebral palsy among survivors.
Cerebral palsy is characterized by abnormal control of movement and posture that results in limitation of activity. It is caused by nonprogressive damage or dysfunction of the developing fetal or infant brain
1
and is a leading cause of chronic childhood disability, with profound medical, emotional, and economic consequences.
2
Preterm birth is a risk factor for cerebral palsy, and the magnitude of the risk is inversely correlated with gestational age at birth.
3
During the past 20 to 30 years, the survival of infants born markedly preterm has improved dramatically, and whereas some data suggest that the rate of cerebral palsy among . . .
Journal Article
Comparison the analgesic effect of magnesium sulphate and Ketorolac in the treatment of renal colic patients: Double-blind clinical trial study
2019
Ureter muscles contraction movements caused pain in renal colic. Magnesium sulphate could influence the pain by reducing acetylcholine in the nerve terminals. We have aimed to evaluate the analgesic effects of magnesium sulphate on acute renal colic pain.
In this double-blind clinical trial study, the patients with renal colic pain were randomly divided into 2 groups; Group I received an intravenous infusion of 30 mg of Ketorolac and normal saline as placebo, Group II 50 mg/kg magnesium sulphate 50%/100 ml normal plus 30 mg of Ketorolac. The pain severity of patients was assessed using the visual analog scale (VAS) at baseline, and 15 and 30 min after intervention.
Baseline pain score and demographic characteristics did not significantly different between the groups. After 30 min the pain score significantly reduced in both groups. While, at 15 and 30 min, mean pain score did not show statistically significant differences.
Our findings indicated that Magnesium sulphate did not influence renal colic pain relief.
Journal Article
A randomized, controlled trial of oral sulfate solution versus polyethylene glycol for bowel preparation for colonoscopy
2025
Background
The quality of colonoscopy is significantly influenced by the effectiveness of bowel preparation. In this study, we aimed to evaluate the efficacy, safety, and tolerability of bowel cleansing between a new oral sulfate solution (OSS) and standard polyethylene glycol electrolyte powder (PEG).
Methods
This single center, randomized, superiority study recruited 679 outpatients who were assigned to either the new OSS group (Group A) or standard PEG group (Group B). The quality of bowel cleansing was evaluated using the Boston Bowel Preparation Scale (BBPS) and compared between the two groups. Furthermore, data pertaining to the duration of bowel preparation, patient tolerability, and the occurrence of adverse events were also analyzed.
Results
According to BBPS scores, group A demonstrated significantly higher bowel preparation cleanliness than group B. Additionally, group A achieved superior bowel cleansing, as evidenced by a greater proportion of patients with BBPS scores ≥ 8 compared to group B (75.3% vs. 55.2%,
P
< 0.05). No severe adverse events were reported during examinations in either group.
Conclusions
The magnesium sulfate, sodium sulfate, and potassium sulfate concentrated oral solution is a novel, safe, and effective bowel preparation for colonoscopy.
Trial registration
This study was registered in the Chinese Clinical Trial Registry on 20/02/2024 (clinical trial registration number: ChiCTR2400081004).
Journal Article
Magnesium sulphate to prevent perioperative atrial fibrillation in cardiac surgery: a randomized clinical trial
by
van den Berg, Lettie
,
Hoohenkerk, Gerard
,
Meerman, Manon
in
Atrial Fibrillation - diagnosis
,
Atrial Fibrillation - etiology
,
Atrial Fibrillation - prevention & control
2024
Background
Postoperative atrial fibrillation (POAF) is a common and potentially serious complication post cardiac surgery. Hypomagnesaemia is common after cardiac surgery and recent evidence indicates that supplementation of magnesium may prevent POAF. We aim to investigate the effectiveness of continuous intravenous magnesium sulphate administration in the perioperative period to prevent POAF as compared to placebo.
Methods
The (POMPAE) trial is a phase 2, single-center, double-blinded randomized superiority clinical study. It aims to assess the impact of perioperative continuous intravenous magnesium administration on the occurrence of cardiac surgery-related POAF. A total of 530 patients will be included. Eligible patients will be randomized in 1:1 ratio to the intervention or placebo group with stratification based on the presence of valvular surgery. The objective of the infusion is to maintain ionized magnesium levels between 1.5 and 2.0 mmol/L.
Discussion
The primary outcome measure is the incidence of de novo POAF within the first 7 days following surgery, with censoring at hospital discharge. This trial may generate crucial evidence for the prevention of POAF and reduce clinical adverse events in patients following cardiac surgery.
Trial registration
The POMPAE trial was registered at ClinicalTrials.gov under the following identifier NTC05669417,
https://clinicaltrials.gov/ct2/show/NCT05669417
. Registered on December 30, 2022.
Protocol version
Version 3.3, dated 13–01-2023.
Journal Article
Efficacy of Magnesium Sulphate as an Adjunct to Lignocaine in Inferior Alveolar Nerve Block for Extraction of Mandibular Third Molar—A Split‐Mouth Double‐Blinded Randomized Controlled Trial
by
Singh, Anupam
,
Gadicherla, Srikanth
,
Kodali, Murali Venkata Rama Mohan
in
Adult
,
Alveoli
,
Analgesics
2025
Background: Extensive ongoing research is aimed at enhancing the efficacy of inferior alveolar nerve block (IANB). Even though magnesium itself is not a primary analgesic, it has been shown to increase the effects of analgesics when used as an adjuvant or a supplement. Magnesium sulphate (MgSO 4 ) has reportedly been used to supplement regional blocks and spinal anaesthesia in various surgical procedures. Building on the concept of MgSO 4 as an analgesic adjuvant, our study aimed to assess its efficacy in increasing IANB success and controlling postsurgical pain. The split‐mouth study evaluated the effectiveness of adding MgSO 4 to 2% lignocaine in improving block success and offering postsurgical pain relief after the transalveolar extraction of impacted mandibular third molars (MTMs). Methodology: We carried out a double‐blinded, randomized, split‐mouth study in 26 patients having bilateral impacted MTM. Patients presenting with impacted MTM bilaterally with a Pederson’s score of ≤ 6 were included. The primary outcomes evaluated were the onset time, duration of anaesthesia, need for additional injections, and burning sensation during injection. The secondary outcomes assessed included postoperative pain relief and the quantity of rescue analgesics required. Results: The test side showed a significantly longer duration of analgesia than the control side ( p < 0.001). The MgSO 4 group showed a lesser requirement for additional injections; however, it was not found to be statistically significant (0.289). No significant differences were seen in postoperative pain and the number of rescue analgesics. Conclusion: The addition of MgSO 4 to 2% lidocaine resulted in a significantly longer duration of analgesia. Trial Registration: CTRI identifier: CTRI/2018/05/013842
Journal Article
Implementation of national guidelines on antenatal magnesium sulfate for neonatal neuroprotection: extended evaluation of the effectiveness and cost-effectiveness of the National PReCePT Programme in England
2026
BackgroundSince 2015, the National Institute for Health and Care Excellence (NICE) guidelines have recommended antenatal magnesium sulfate (MgSO4) for mothers in preterm labour (<30 weeks’ gestation) to reduce the risk of cerebral palsy (CP) in the preterm baby. However, the implementation of this guideline in clinical practice was slow, and MgSO4 use varied between maternity units. In 2018, the PRrevention of Cerebral palsy in PreTerm labour (PReCePT) programme, an evidence-based quality improvement (QI) intervention to improve use of MgSO4, was rolled out across England. Earlier evaluation found this programme to be effective and cost-effective over the first 12 months. We extended the original evaluation to determine the programme’s longer-term impact over 4 years, its impact in later preterm births, the impact of the COVID-19 pandemic, and to compare MgSO4 use in England (where PReCePT was implemented) to Scotland and Wales (where it was not).MethodsQuasi-experimental longitudinal study using data from the National Neonatal Research Database on babies born <30 weeks’ gestation and admitted to a National Health Service neonatal unit. Primary outcome was the percentage of eligible mothers receiving MgSO4, aggregated to the national level. Impact of PReCePT on MgSO4 use was estimated using multivariable linear regression. The net monetary benefit (NMB) of the programme was estimated.ResultsMgSO4 administration rose from 65.8% in 2017 to 85.5% in 2022 in England. PReCePT was associated with a 5.8 percentage points improvement in uptake (95% CI 2.69 to 8.86, p<0.001). Improvement was greater when including older preterm births (<34 weeks’ gestation, 8.67 percentage points, 95% CI 6.38 to 10.96, p<0.001). Most gains occurred in the first 2 years following implementation. PReCePT had a NMB of £597 000 with 89% probability of being cost-effective. Following implementation, English uptake appeared to accelerate compared with Scotland and Wales. There was some decline in use coinciding with the onset of the pandemic.ConclusionsThe PReCePT QI programme cost-effectively improved use of antenatal MgSO4, with anticipated benefits to the babies who have been protected from CP.
Journal Article
Effect of low-molecular-weight heparin calcium combined with magnesium sulfate and labetalol on coagulation, vascular endothelial function and pregnancy outcome in early-onset severe preeclampsia
2024
Objective
This paper was aimed at unveiling the effect of low-molecular-weight heparin calcium (LMWH) combined with magnesium sulfate and labetalol on coagulation, vascular endothelial function, and pregnancy outcome in early-onset severe preeclampsia (EOSP).
Methods
Pregnant women with EOSP were divided into the control group and the study group, each with 62 cases. Patients in the control group were treated with labetalol and magnesium sulfate, and those in the study group were treated with LMWH in combination with the control grou Blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP]), 24-h urine protein, coagulation indices [D-dimer (D-D), plasma fibrinogen (Fg), prothrombin time (PT), activated partial thromboplastin time (APTT), and prothrombin time (TT)], endothelial function [endothelin (ET-1) and nitric oxide (NO)], oxidative stress indices [oxidized low-density lipoproteins (ox-LDL), lipid peroxidation (LPO), superoxide dismutase (SOD), and malondialdehyde (MDA)], pregnancy outcome, and adverse effects occurred in the two groups were compared.
Results
After treatment, lower SBP, DBP, and 24-h urine protein levels; lower Fg and D-D levels; higher PT, APPT, and TT levels; higher NO levels; lower ET-1 levels; lower ox-LDL, MDA, and LPO levels; higher SOD levels; and lower incidence of adverse pregnancy and adverse reactions were noted in the study group in contrast to the control group.
Conclusion
EOSP patients given with LMWH combined with magnesium sulfate and labetalol can effectively reduce the patient’s blood pressure and urinary protein level; improve coagulation function, oxidative stress, and vascular endothelial function indices; reduce the adverse pregnancy outcomes; and improve the safety of treatment.
Journal Article
Use of intravenous magnesium sulfate in addition to standard first-line treatment with inhaled/nebulised short-acting beta 2 agonist and systemic steroids in the management of acute asthma exacerbations in children: a systematic review and meta-analyses of randomised controlled trials
2025
BackgroundThe role of intravenous magnesium sulfate in asthma exacerbation is unclear.AimsTo determine the efficacy and safety of intravenous magnesium sulfate in managing asthma exacerbation in children.MethodsWe searched MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials and the Web of Science up to May 2024. We included randomised controlled trials and followed the international guidelines for conducting systematic reviews. Outcomes included morbidity, escalation of care, length of hospital stay, lung functions, adverse events, and mortality.ResultsNine studies (total participants=473) were included. Hospitalisation rate and the need for non-invasive ventilation were less among the intravenous magnesium sulfate group (mean difference (MD)=0.70, 95% CI 0.54 to 0.90, I2 7%, n=115) and (risk ratio (RR)=0.17, 95% CI 0.15 to 0.54, p=0.003, n=143), respectively. Asthma severity scores (MD=−0.18, 95% CI −1.35 to 0.98, I2 2%, n=115), length of hospital stay (MD=−78.86, 95% CI −200.37 to 42.66, I2 99%, n=284) and the need for invasive ventilation (RR=0.35, 95% CI 0.11 to 1.17, I2 0%, n=237) were similar. There was no difference in the Paediatric Intensive Care Unit (PICU) admission rate (p=0.43 n=61). Peak expiratory flow improved in the intravenous magnesium group (p<0.001, n=20). No serious adverse events were reported.ConclusionWe found low-certainty evidence that intravenous magnesium sulfate results in a lower hospitalisation rate and less need for non-invasive ventilation. Asthma scores, PICU admission, invasive ventilation and length of hospital stay were similar. While the evidence base is weak, the favourable safety profile suggests that intravenous magnesium sulfate can be considered a treatment for asthma exacerbations.PROSPERO registration numberCRD42023405261.
Journal Article