Magnesium and Intraoperative Blood Loss in Meningioma Surgery

NCT ID: NCT03558516

Last Updated: 2020-07-13

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-01

Study Completion Date

2020-02-18

Brief Summary

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Meningioma is the most common central nervous system tumor and craniotomy with tumor removal was associated with moderate blood loss and blood transfusion. Magnesium has hypotensive effect and probably reduce intraoperative blood loss. Whether or not magnesium sulphate can reduce intraoperative blood loss and improve postoperative cognitive function is still inconclusive. So the investigators conduct the randomized control trial to compare the effect of magnesium with placebo control in blood loss and cognitive function in meningioma patient undergoing craniotomy.

Detailed Description

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The investigators enroll 120 patient who admitted for craniotomy for meningioma removal. Then, the patients will be divided into two groups. The first group or group Mg will receive magnesium sulphate 40 mg/kg infuse for 30 min (started at skin incision), and then infuse magnesium sulphate 10 mg/kg/hr until the dura will be closed. The another group or normal saline group will receive the same amount of 0.9% sodium chloride. The anesthesia and surgery are standardized. The recorded data include patient demographic data, intraoperative blood loss, hemodynamics and pre and postoperative Montreal cognitive assessment score.

Conditions

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Meningioma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

We compare intraoperative blood loss in two group between the magnesium (study group) and 0.9% sodium chloride group (control group)
Primary Study Purpose

OTHER

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors
The study drug will prepared by the investigator in the same character and amount. So the patient and care provider will not know the study drug is magnesium or 0.9% sodium chloride.

Study Groups

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Magnesium group

The patient will receive magnesium sulfate injection 40 mg/kg infuse over 30 min started at skin incision and continuous drip 10 mg/kg/hr until the dura is closed

Group Type EXPERIMENTAL

Magnesium group

Intervention Type DRUG

We will dilute magnesium 6 gram with 0.9% sodium chloride to 30 ml. The patient will receive magnesium sulfate 40 mg/kg infuse over 30 min started at skin incision and continuous drip 10 mg/kg/hr until the dura is closed. Anesthesia is standardized with propofol, fentanyl, cisatracurium and sevoflurane. Vasopressor or antihypertensive drug are used to control hemodynamics.

Normal saline group

The patient will receive 0.9% sodium chloride the same amount of magnesium sulphate infuse over 30 min started at skin incision and continuous drip until the dura is closed

Group Type PLACEBO_COMPARATOR

Normal saline group

Intervention Type DRUG

The patient will receive 0.9% sodium chloride the same amount of magnesium sulphate infuse over 30 min started at skin incision and continuous drip until the dura is closed. Anesthesia is standardized with propofol, fentanyl, cisatracurium and sevoflurane. Vasopressor or antihypertensive drug are used to control hemodynamics.

Interventions

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Magnesium group

We will dilute magnesium 6 gram with 0.9% sodium chloride to 30 ml. The patient will receive magnesium sulfate 40 mg/kg infuse over 30 min started at skin incision and continuous drip 10 mg/kg/hr until the dura is closed. Anesthesia is standardized with propofol, fentanyl, cisatracurium and sevoflurane. Vasopressor or antihypertensive drug are used to control hemodynamics.

Intervention Type DRUG

Normal saline group

The patient will receive 0.9% sodium chloride the same amount of magnesium sulphate infuse over 30 min started at skin incision and continuous drip until the dura is closed. Anesthesia is standardized with propofol, fentanyl, cisatracurium and sevoflurane. Vasopressor or antihypertensive drug are used to control hemodynamics.

Intervention Type DRUG

Other Intervention Names

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Mg NSS

Eligibility Criteria

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Inclusion Criteria

* Meningioma patient
* Schedule for supratentorial craniotomy with tumor removal
* American society of anesthesiologists physical status 1-3
* Age 18-70 years
* No alteration of conscious (full Glasgow coma score) and well cooperate
* Expected to extubation after operation

Exclusion Criteria

* Unstable hemodynamic (severe hypotension or hypertension who receive antihypertensive and vasopressor before surgery but not include baseline oral antihypertensive drug)
* Known cardiac disease from either history, physical examination or investigation
* Patient who have heart block
* Hepatic disease (Child Pugh Score Class C)
* Renal insufficiency (eGFR \< 60 ml/min from Chronic Kidney Disease Epidemiology Collaboration equation)
* Allergy to magnesium or other drugs use in the study
* Patient who receive calcium channel blocker drug
* Pregnancy
* Patient who receive magnesium for treatment such as arrhythmia or preeclampsia
* Hypermagnesemia (more than 2.6 mg/dL) before surgery
* BMI more than 30 kg/m2
* Patient who probably have brain herniation from increase intracranial pressure
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mahidol University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Manee Raksakietisak, M.D.

Role: PRINCIPAL_INVESTIGATOR

Mahidol University

Locations

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Faculty of medicine, Siriraj hospital, Mahidol University

Bangkok, , Thailand

Site Status

Countries

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Thailand

References

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Reference Type BACKGROUND
PMID: 24137015 (View on PubMed)

Wiemels J, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neurooncol. 2010 Sep;99(3):307-14. doi: 10.1007/s11060-010-0386-3. Epub 2010 Sep 7.

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Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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SI 259/2018

Identifier Type: -

Identifier Source: org_study_id

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