LMA Versus Mgso4 in Attenuating Stress Response During Emergence of Supratentorial Tumours Patients Clinical Trial
Official title:
A Comparative Study Between Laryngeal Mask Airway and Magensium Sulphate in Attenuating Systemic Stress Response During Emergence of Patients Undergoing Supratentorial Tumours.
To evaluate the efficacy of replacement of ETT with LMA and administration of Magnesium sulphate at the end of the surgery in attenuating systemic stress response during emergence of patients undergoing supratentorial tumours
Rapid recovery from neuroanesthesia and early neurological examination are desirable in most
cases.(1)Although, Systemic and cerebral hemodynamic changes caused by extubation and
emergence from anesthesia may endanger neurosurgical patients and increase the risk of
postoperative intracranial hemorrhage and cerebral edema and may even result in the
requirement of reoperation.(2) During this phase, heart rate and arterial blood pressure
increase leading to increases in cerebral blood flow and intracranial pressure.(3) Some
studies have reported such hemodynamic effects in up to 50% of patients after supratentorial
craniotomy.(4,5) Replacing the endotracheal tube (ETT) with laryngeal mask airway (LMA) prior
to emergence from anesthesia is safe and effectively reduces the cardiovascular response.(6)
The potential protective benefit of this approach has not yet been demonstrated for awakening
neurosurgery patients, however.
Magnesium is the forth most abundant cation in the body and the second most abundant
intracellular cation. It activates many of the enzyme systems.(7) Magnesium sulphate inhibits
catecholamines release from adrenergic nerve terminals and from adrenal medulla, through
blocking N-type of Ca-channel at peripheral sympathetic nerve ending so it is used to
decrease the adverse cardiovascular effects during larygeoscopy and endotracheal
intubation.(8) But its role in attenuating stress response during extubation is not well
studied and need more research.
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