Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942013000100012
Brazilian Journal of Anesthesiology
Review Article

Efeitos neurotóxicos de sulfato de magnésio intratecal

Neurotoxic effects of intrathecal magnesium sulphate

Levent Ozdogan; Handan Sastim; Dilsen Ornek; Aysun Postaci; Taner Ayerden; Bayazit Dikmen

Downloads: 2
Views: 690

Resumo

JUSTIFICATIVA E OBJETIVOS: Avaliar os potenciais efeitos neurotóxicos em nível ultraestrutural desulfato de magnésio administrado por via intratecal em dose única ou múltipla. MÉTODOS: Estudo realizado com 24 ratos Sprague-Dawley, peso médio entre 250 e 300 g. Apósjejum de 4 horas, os ratos receberam 10 mg.kg-1 de cloreto de xilazina por via intraperitoneale, em seguida, foram divididos aleatoriamente em três grupos. Grupo I (n = 8) recebeu 0,9% desoro fisiológico normal, Grupo II (n = 8) recebeu uma injeção de 0,02 mL de sulfato de magnésioa 15% por via intratecal e Grupo III (n = 8) recebeu 0,02 mL de sulfato de magnésio a 15% umavez por dia durante sete dias. As injeções foram aplicadas dentro de 0,40x50 milímetros daárea lombar. Após sete dias, os animais foram sacrificados sob anestesia com uma injeção deformaldeído a 10% na aorta e os tecidos foram fixados. A medula espinal foi, então, examinadae histopatologicamente avaliada sob microscópio eletrônico. O teste de Kruskal-Wallis foi usadopara avaliação estatística. Um valor de p < 0,05 foi considerado estatisticamente significativo. RESULTADOS: Neurodegeneração significativa foi detectada nos ratos que receberam uma únicainjeção ou injeções repetidas de sulfato de magnésio, em comparação com o grupo controle. O escore na avaliação histopatológica desse grupo também foi alto. CONCLUSÃO: Com base no exame de microscopia eletrônica, descobrimos que a administraçãointratecal de sulfato de magnésio induziu neurodegeneração.

Palavras-chave

Infusão Espinal, Microscopia Eletrônica, Sulfato de Magnésio, Toxicidade

Abstract

BACKGROUND AND OBJECTIVES: To assess the potential neurotoxic effects at the ultrastructural level of magnesium sulfate administered intrathecally as a single or multi-dose. METHODS: Our study was conducted with 24 Sprague-Dawley rats that weighed 250-300 g. After a 4-hour fast, the rats were given 10 mg.kg-1 xylazine chloride intraperitoneal and then randomly allocated into three groups. Group I (n = 8) received 0.9% normal saline, Group II (n = 8) was given one intrathecal injection of 0.02 mL of 15% magnesium sulphate, and Group III (n = 8) was given 0.02 mL of 15% magnesium sulphate once a day for seven days. The injections were given within 0.40x50 mm from the lumbar area. After seven days, the animals were sacrificed under anesthesia with an aortic injection of 10% formaldehyde and their tissues were fixed. The medulla spinalis was then examined and histopathologically evaluated under an electron microscope. The Kruskal-Wallis test was used for statistical evaluation. A value of p < .05 was considered to be statistically significant. RESULTS: Significant neurodegeneration was detected in rats given single or repeated magnesium sulphate injections compared to the control group. The histopathological evaluation score of this group was also high. CONCLUSIONS: Based on electron microscopic examination, we found that intrathecal magnesium sulphate administration induced neurodegeneration.

Keywords

Magnesium Sulphate, Injections, Spinal, Toxic Actions, Microscopy, Electron

References

Barash PG, Culen BF, Stoelting RF. Handbook of clinical anesthesia, management of acute post-operative pain. 1997:1547-1577.

Asokumar B, McCarthy RJ, Korin JS, Leong W, Perry P, Tuman KJ. Intrathecal magnesium prolongs fentanyl analgesia. Aneth Analg. 2002;95:661-666.

Ko S, Lim H, Kim D, Han Y, Choe H, Song H. Magnesium sulphate does not reduce postoperative analgesic requirements. Anesthesiology. 2001;95:640-646.

Dror A, Henriksen E. Accidental epidural magnesium sulphate injection. Anesth Analg. 1987;66:1020-1021.

Lejuste MJ. Inadvertent intrathecal administration of magnesium of magnesium sulphate. S Afr Med J. 1985;68(6):367-368.

Uğur G, Erhan Y, Yegül I. Effects of two different anesthetic medicine on spinal cord and nerve roots. Ege University, Medical Faculty Journal. 1985;24:221-236.

Meltzer SJ, Auer J. Physiological and pharmacological studies of magnesium salts: 2. The toxicity of intravenous injections, in particular the effects upon the centers of the medulla. Am J Physiol. 1996;15:387-405.

Zalago G, Eisenach JC. Magnesium, anesthesia, and hemodynamic control. Anesthesiology. 1991;74:1-10.

Bahar M, Berman S, Chanimov M, Weissgarten J, Averbukh Z, Cohen ML. Intrathecal anesthesia alters intracellular calcium/magnesium homeostasis in the spinal cord neurons of experimental rats. European Journal of Anesthesiology. 2001;18:231-237.

Mitani A, Watanabe M, Kataoka K. Functional change of NMDA receptors related to enhancement of susceptibility to neurotoxicity in the developing pontine nucleus. J Neurosci. 1998;18(19):7941-7952.

Fawcett WJ, Haxby EJ, Male DA. Magnesium physiology and pharmacology. . 1990;83:302-320.

Martyn JA, Standaert FG, Miller RD. Neuromuscular physiology and pharmacology. Anesthesia. 2000:735-751.

Chanimov M, Cohen ML, Grinspun Y, Herbert M, Reif R, Kaufman I, Bahar M. Neurotoxicity after spinal anesthesia induced by serial intrathecal injections of magnesium sulphate. Anaesthesia. 1997;52:223-228.

Bahar M, Chanimov M, Grinspun E, Koafman I, Cohen ML. Spinal anaesthesia by intrathecal magnesium sulphate. Anaesthesia. 1996;51:627-633.

Diba A. Magnesium sulphate spinal anesthesia: Correspondence. Anaesthesia. 1997;52:187-188.

Koinig H, Wallner T, Marhofer P, Andel H, Hörauf K, Mayer N. Magnesium sulphate reduces intra and postoperative analgesic requirements. Anesth Analg. 1998;87:206-210.

Cheng C, Reynolds IJ. Subcellular localization of glutamate stimulated intracellular magnesium concentration changes in cultured rat forebrain neurons using confocal microscopy. Neuroscience. 2000;95(4):973-979.

Nuutinen L, Laitinen J. A risk-benefit appraisal of injectable NSAID's in the management of postoperative pain. Drug Safety. 1993;9(5):380-393.

Ready LB, Plummer MH, Haschke RH. Neurotoxicity of intrathecal local anesthetics in rabbits. Anesthesiology. 1985;63:364-370.

Malinovksy JM, Lepage JY, Cozian A, Mussini JM, Pinaudt M. Is ketamine or its preservative responsible for neurotoxicity in the rabbit?. Anaesthesiology. 1993;78:109-115.

Coombs DW, Fratkin JD. Neurotoxicology of spinal agents. Anesthesiology. 1987;66:724-726.

Gordh T Jr, Post C, Olsson Y. Evaluation of the toxicity of subarachnoid clonidine, guanfacine and a substance P antagonist on rat spinal cord and nerve roots. Anesth Analg. 1986;65:1303-1311.

Myers R, Kalichman M, Reisner L, Powell H. Neurotoxicity of local anesthetics: Altered perineural permeability, edema, and nerve fiber injury. Anesthesiology. 1986;64:29-35.

Rodgson PS, Neal JM, Pollock JE, Liu S. The neurotoxicity of drugs given intrathecally. Anesth Analg. 1999;88:797-809.

Pockett S. Spinal cord synaptic plasticity and chronic pain. Anesth Analg. 1995;80:173-179.

5dd438510e88254254c63497 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections