- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01148888
The Effect of Magnesium Sulfate on Motor and Somatosensory Evoked Potentials in Children Undergoing Scoliosis Surgery
Study Overview
Detailed Description
Motor and somatosensory evoked potentials are continuously monitored in the setting of scoliosis surgery to evaluate the integrity of spinal cord pathways. Detection of neural irritation or injury using motor or somatosensory evoked potentials allows the surgeon to modify technique to reverse the insult and proceed without spinal cord compromise. To facilitate evoked potential monitoring, anesthetic agents that attenuate the evoked responses must be avoided.Several different agents have been studied to try to diminish the acute opioid tolerance and/or hyperalgesia seen with remifentanil.
Two studies investigated the effect of magnesium sulfate on intraoperative remifentanil-induced hyperalgesia. In both studies, post-operative pain scores and opioid consumption were decreased in those patients who received magnesium.
Our aim is to establish that magnesium sulfate does not adversely affect somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) in patients undergoing correction of idiopathic scoliosis. Future clinical trials can then be performed investigating the effect of magnesium sulfate on remifentanil-induced hyperalgesia in the same population.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Ontario
-
Toronto, Ontario, Canada, M5G 1X8
- The Hospital for Sick Children
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- American Society of Anesthesiologists (ASA) status I or II
- Adolescent children aged 12 to 18 years undergoing surgery for idiopathic scoliosis
Exclusion Criteria:
- Magnesium use within the last two weeks, either intravenous or oral supplements
- Patients with known electrolyte imbalances or conduction disorders. (Sodium <135 or >143 mmol/L OR Potassium < 3.7 or > 5.0 mmol/L if 12 to 15 yrs; Potassium <3.7 or >4.8 mmol/L if 16 to 18 yrs)
- Renal, cardiac or neuromuscular disorders.(Urea < 2.9 or > 7.1 mmol/L OR Creatinine >79 µmol/L if < 13 yrs; Creatinine > 98 µmol/L if >= 14 yrs)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Magnesium Sulfate
The study will be conducted in the 45 minute interval between the completion of spinal instrumentation and the completion of skin closure.
Once the spinal instrumentation is complete and the integrity of the spinal cord pathways is confirmed using SEPs and MEPs, magnesium will be administered for the remainder of surgery.
|
Magnesium will be administered intravenously at a dose of 50 mg/kg bolus followed by an infusion of 10 mg/kg/hr.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Somatosensory and motor evoked potentials
Time Frame: Baseline
|
Cortical SEPs will be measured from Cz-Fpz or Ci-Cc (10-20 system of head measurement) and the amplitudes will be taken from the first positive deflection to first negative deflection (P1-N1) after supramaximal stimulation of the posterior tibial nerves at the medial malleolus.
The MEP peak-to-peak amplitudes will be measured from left and right tibialis anterior and abductor hallucis muscles.
Stimulation parameters will be varied in order to achieve the maximum amplitude values.
Evoked potentials will be measured before and at 10 and 30 minutes after the start of the magnesium infusion.
|
Baseline
|
Somatosensory and motor evoked potentials
Time Frame: 10 and 30 minutes after the start of the magnesium infusion
|
Cortical SEPs will be measured from Cz-Fpz or Ci-Cc (10-20 system of head measurement) and the amplitudes will be taken from the first positive deflection to first negative deflection (P1-N1) after supramaximal stimulation of the posterior tibial nerves at the medial malleolus.
The MEP peak-to-peak amplitudes will be measured from left and right tibialis anterior and abductor hallucis muscles.
Stimulation parameters will be varied in order to achieve the maximum amplitude values.
Evoked potentials will be measured before and at 10 and 30 minutes after the start of the magnesium infusion.
|
10 and 30 minutes after the start of the magnesium infusion
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Mark Crawford, MD, The Hospital for Sick Children, Toronto Canada
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1000014574
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Scoliosis
-
Manhattan Physical Medicine and Rehabilitation,...RecruitingScoliosis Idiopathic | Scoliosis; Adolescence | Scoliosis; Lumbar RegionUnited States
-
Stanford UniversityNational Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)Not yet recruitingScoliosis Idiopathic | Spondylolisthesis | Scoliosis; Adolescence | Kyphosis | Juvenile; Scoliosis | Scoliosis;CongenitalUnited States
-
Seattle Children's HospitalJohns Hopkins University; Duke University; Vanderbilt University; University of... and other collaboratorsRecruitingScoliosis Idiopathic | Spondylolisthesis | Scoliosis; Adolescence | Kyphosis | Juvenile; Scoliosis | Scoliosis;CongenitalUnited States
-
Children's National Research InstituteNational Institute for Biomedical Imaging and Bioengineering (NIBIB); Kitware...RecruitingScoliosis Idiopathic | Scoliosis; JuvenileUnited States
-
University of HaifaRecruitingScoliosis Idiopathic | Scoliosis; AdolescenceIsrael
-
University of PecsCompletedScoliosis Idiopathic | Scoliosis, SevereHungary
-
Istituto Scientifico Italiano Colonna VertebraleCompletedScoliosis Idiopathic | Scoliosis; AdolescenceItaly
-
Istituto Scientifico Italiano Colonna VertebraleRecruiting
-
Stanford UniversityRecruitingScoliosis; Juvenile | Scoliosis; AdolescenceUnited States
-
Istanbul Gelisim UniversityCompletedScoliosis Idiopathic | Scoliosis; AdolescenceTurkey
Clinical Trials on Magnesium
-
Sir Charles Gairdner HospitalUnknownChronic Kidney Diseases | End Stage Renal Disease | Dialysis Related Complications
-
Zydus Therapeutics Inc.Suspended
-
Zydus Therapeutics Inc.CompletedNon Alcoholic SteatohepatitisUnited States
-
Salem Anaesthesia Pain ClinicRecruitingSteroid Metabolism DisorderCanada
-
Sohag UniversityNot yet recruiting
-
Zydus Therapeutics Inc.RecruitingPrimary Biliary CholangitisUnited States, Argentina, Iceland, Turkey
-
National Center for Complementary and Integrative...Completed
-
National Heart, Lung, and Blood Institute (NHLBI)CompletedMyocardial Infarction | Myocardial Ischemia | Heart Diseases | Cardiovascular Diseases | Coronary Disease
-
Zydus Therapeutics Inc.CompletedNonalcoholic Steatohepatitis | Non-Alcoholic Fatty Liver DiseaseUnited States
-
Mayo ClinicRecruitingBladder SpasmsUnited States