Dexmedetomidine Versus Magnesium Sulfate Infusion in Craniotomy

NCT ID: NCT07199595

Last Updated: 2025-09-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-20

Study Completion Date

2026-11-01

Brief Summary

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To compare the intraoperative effects of Dexmedetomidine and Magnesium Sulfate infusion on intracranial pressure and cerebral perfusion pressure in adult patients undergoing craniotomy

Detailed Description

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Intracranial pressure (ICP) and cerebral perfusion pressure (CPP) are critical parameters in craniotomy patients . Effective modulation of these pressures during surgery can improve intraoperative stability and postoperative recovery . Dexmedetomidine (Dexamed) is a selective α2-adrenoceptor agonist with sedative and neuroprotective properties, known to reduce ICP without respiratory depression . Magnesium Sulfate (MgSO₄) acts as an NMDA receptor antagonist and vasodilator, promoting neuronal protection and improved cerebral blood flow . By using a lumbar drain catheter intraoperatively, direct and continuous measurement of ICP is feasible, offering real-time insight into the pharmacological effects of these agents on cerebral dynamics .

The underlying research question is as follows: Can intraoperative Dexmedetomidine as opposed to Magnesium sulfate result in better ICP and CPP management of adult craniotomy patients? Nonetheless, the individual basis of usage of Dexmedetomidine and Magnesium Sulfate in neurosurgeries has been supported by existing literature , but lack of direct comparative studies to determine the effects of the two drugs on real-time intracranial and cerebral perfusion pressure in the craniotomy . This study aims to fill the existing gap in the literature by stating the continuity of ICP monitoring with a lumbar drain, thus offering a robust and standard control environment of comparison.

Intervention Protocol

Participants will be randomly assigned to one of two groups:

Group A - Dexmedetomidine Infusion

* Loading Dose: 1 µg/kg IV over 10 minutes
* Maintenance Infusion: 0.2-0.7 µg/kg/h, titrated based on sedation level and hemodynamic response
* Infusion will carry on till skin closure.
* Monitoring: MAP, HR, ICP, CPP Group B - Magnesium Sulfate Infusion
* Loading Dose: 20 mg/kg IV over 15 minutes
* Maintenance Infusion: 10 mg/kg/h throughout the procedure
* Infusion will carry on till skin closure.
* Monitoring: MAP, HR, ICP, CPP

Conditions

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Craniotomy Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Participants

Study Groups

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Dexmedetomidine

Dexmedetomidine: loading dose 1 µg/kg IV over 10 min after induction and then maintenance dose 0.2- 0.7 µg/kg/hr based on hemodynamic response

Group Type ACTIVE_COMPARATOR

Dexamedomedine

Intervention Type DRUG

Group A (the Dexmedetomidine group):

Dexmedetomidine: loading dose 1 µg/kg IV over 10 min after induction and then maintenance dose 0.2- 0.7 µg/kg/hr based on hemodynamic response.

Mgso4

Magnesium Sulfate: Used as an IV loading dose at 20 mg/kg IV over 17 minutes as an induction agent, followed by maintenance of 10 mg/kg/h to skin closure.

Group Type ACTIVE_COMPARATOR

MgSO4

Intervention Type DRUG

Magnesium Sulfate: Used as an IV loading dose at 20 mg/kg IV over 17 minutes as an induction agent, followed by maintenance of 10 mg/kg/h

Interventions

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Dexamedomedine

Group A (the Dexmedetomidine group):

Dexmedetomidine: loading dose 1 µg/kg IV over 10 min after induction and then maintenance dose 0.2- 0.7 µg/kg/hr based on hemodynamic response.

Intervention Type DRUG

MgSO4

Magnesium Sulfate: Used as an IV loading dose at 20 mg/kg IV over 17 minutes as an induction agent, followed by maintenance of 10 mg/kg/h

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age 18-65 years
* Elective craniotomy for supratentorial pathology
* No contraindication to lumbar drain insertion
* Baseline mental status is stable, allowing for a reliable postoperative neurological evaluation can be done
* ASA physical status I-III

Exclusion Criteria

* Coagulopathy or current anticoagulation
* Severe renal or hepatic dysfunction
* Known allergy to study medications
* traumatic brain injury
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Hassan mostafa abdelbaky ahmed

Assistant lecturer

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Hassan mostafa, Assistant lecturer

Role: CONTACT

Phone: 01060264751

Email: [email protected]

Ghada Aboalfadl, Professor

Role: CONTACT

Email: [email protected]

Other Identifiers

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Icp

Identifier Type: -

Identifier Source: org_study_id