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BMC Oral Health Sep 2022Myofascial pain syndrome with trigger points is the most common cause of nonodontogenic pain. Although injection of the trigger points is the most effective pain... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Myofascial pain syndrome with trigger points is the most common cause of nonodontogenic pain. Although injection of the trigger points is the most effective pain reduction treatment, many patients exhibit recurrence after a short period. Therefore, the aim of the current study was to evaluate the clinical efficacy of magnesium sulfate injections in the treatment of the masseter muscle trigger points when compared to saline injections.
MATERIAL AND METHOD
This study randomly (1:1) assigned 180 patients to one of two treatment groups based on whether their trigger points were injected with 2 ml of saline or magnesium sulfate. Pain scores, maximum mouth opening (MMO), and quality of life were measured at the pre-injection and 1, 3, and 6 months post-injection.
RESULTS
The pain scores were significantly higher in the saline group during all follow-up assessments, whereas the MMO was significantly higher in the magnesium sulfate group up to 3 months of follow-up (p < 0.001). However, the difference in MMO ceased to be statistically significant after 6 months of follow-up (p = 0.121). Additionally, the patient's quality of life score was significantly higher in the magnesium sulfate group compared to the saline group (p < 0.001).
CONCLUSION
Injection of magnesium sulfate is an effective treatment measure for myofascial trigger points. However, further studies with a proper design addressing the limitations of the current study are necessary.
CLINICALTRIALS
org (ID: NCT04742140) 5/2/2021.
Topics: Humans; Magnesium Sulfate; Masseter Muscle; Pain; Quality of Life; Treatment Outcome; Trigger Points
PubMed: 36123724
DOI: 10.1186/s12903-022-02452-3 -
Acta Obstetricia Et Gynecologica... Apr 2023Preterm delivery and its complications are among the biggest challenges and health risks in obstetrical practice. Several tocolytic agents are used in clinical practice,...
INTRODUCTION
Preterm delivery and its complications are among the biggest challenges and health risks in obstetrical practice. Several tocolytic agents are used in clinical practice, although the efficacy and side effect profiles of these drugs are not satisfying. The aim of this study was to investigate the uterus relaxant effect of the coadministration of β -mimetic terbutaline and magnesium sulfate (MgSO ) in an isolated organ bath and to perform in vivo smooth muscle electromyographic (SMEMG) studies in pregnant rats. In addition, we also investigated whether the tachycardia-inducing effect of terbutaline can be reduced by the presence of magnesium, due to the opposite heart rate modifying effects of the two agents.
MATERIAL AND METHODS
In the isolated organ bath studies, rhythmic contractions of 22-day- pregnant Sprague-Dawley rats were stimulated with KCl, and cumulative dose-response curves were constructed in the presence of MgSO or terbutaline. The uterus-relaxing effects of terbutaline were also investigated in the presence of MgSO in both normal buffer and Ca -poor buffer. The in vivo SMEMG studies were carried out under anesthesia with the subcutaneous implantation of an electrode pair. The animals were treated with MgSO or terbutaline alone or in combination in a cumulative bolus injection. The implanted electrode pair also detected the heart rate.
RESULTS
Both MgSO and terbutaline reduced uterine contractions in vitro and in vivo, furthermore, the administration of a small dose of MgSO significantly enhanced the relaxant effect of terbutaline, especially in the lower range. However, in Ca -poor environment, MgSO was not able to increase the effect of terbutaline, indicating the role of MgSO as a Ca channel blocker. In the cardiovascular studies, MgSO significantly decreased the tachycardia-inducing effect of terbutaline in late pregnant rats.
CONCLUSIONS
The combined application of MgSO and terbutaline may have clinical significance in tocolysis, which must be confirmed in clinical trials. Furthermore, MgSO could substantially reduce the tachycardia-inducing side effect of terbutaline.
Topics: Pregnancy; Female; Rats; Animals; Terbutaline; Magnesium Sulfate; Rats, Sprague-Dawley; Tocolytic Agents; Uterus
PubMed: 36808376
DOI: 10.1111/aogs.14532 -
Journal of Cerebral Blood Flow and... Apr 2017Magnesium sulfate is now widely recommended for neuroprotection for preterm birth; however, this has been controversial because there is little evidence that magnesium...
Magnesium sulfate is now widely recommended for neuroprotection for preterm birth; however, this has been controversial because there is little evidence that magnesium sulfate is neuroprotective. Preterm fetal sheep (104 days gestation; term is 147 days) were randomly assigned to receive sham occlusion (n = 7), i.v. magnesium sulfate (n = 10) or saline (n = 8) starting 24 h before asphyxia until 24 h after asphyxia. Sheep were killed 72 h after asphyxia. Magnesium sulfate infusion reduced electroencephalograph power and fetal movements before asphyxia. Magnesium sulfate infusion did not affect electroencephalograph power during recovery, but was associated with marked reduction of the post-asphyxial seizure burden (mean ± SD: 34 ± 18 min vs. 107 ± 74 min, P < 0.05). Magnesium sulfate infusion did not affect subcortical neuronal loss. In the intragyral and periventricular white matter, magnesium sulfate was associated with reduced numbers of all (Olig-2+ve) oligodendrocytes in the intragyral (125 ± 23 vs. 163 ± 38 cells/field) and periventricular white matter (162 ± 39 vs. 209 ± 44 cells/field) compared to saline-treated controls ( P < 0.05), but no effect on microglial induction or astrogliosis. In conclusion, a clinically comparable dose of magnesium sulfate showed significant anticonvulsant effects after asphyxia in preterm fetal sheep, but did not reduce asphyxia-induced brain injury and exacerbated loss of oligodendrocytes.
Topics: Animals; Brain; Disease Models, Animal; Electroencephalography; Fetal Hypoxia; Gestational Age; Magnesium Sulfate; Neuroprotective Agents; Sheep
PubMed: 27317658
DOI: 10.1177/0271678X16655548 -
Developmental Neuroscience 2018Magnesium is an intracellular cation essential for many en-zymatic processes and cellular functions. Magnesium sulfate acts as an endogenous calcium channel antagonist... (Review)
Review
Magnesium is an intracellular cation essential for many en-zymatic processes and cellular functions. Magnesium sulfate acts as an endogenous calcium channel antagonist at neuronal synapses, thought to prevent excessive activation of N-methyl-D-aspartate receptors by excitatory amino acids, such as glutamate, and by downregulation of proinflammatory pathways. Early intervention is essential in the prevention of the secondary phase of neuronal injury. The immature brain is particularly prone to excitotoxicity, and inflammation has been strongly implicated in the pathogenesis of cerebral palsy. This article explores the current status of magnesium being used as an adjunct to hypothermia in term neonatal encephalopathy (NE) against a background of its use in other populations. There is some evidence for magnesium sulfate as a neuroprotective agent, however animal studies of NE at term equivalent age have been confounded by concomitant hypothermia induced by magnesium itself. Nevertheless, the combination of magnesium and cooling has been shown to be more effective than either treatment alone in adult rodents. In the preterm baby, magnesium sulfate given antenatally in threatened preterm labor has demonstrated a significant reduction in the risk of cerebral palsy at 2 years of age, though the benefit is not clear at school age. In adult clinical studies of ischemic and hemorrhagic stroke, there have been disappointing results for magnesium sulfate as a neuroprotective strategy. Importantly, clinical neurological scores may be affected by the increased hypotonia observed. We suggest that magnesium sulfate should be carefully re-evaluated as a neuroprotective agent given its favorable safety profile, relative low cost, and widespread availability.
Topics: Adult; Animals; Brain; Brain Diseases; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Magnesium Sulfate; Neuroprotective Agents; Stroke
PubMed: 29408814
DOI: 10.1159/000484891 -
Archives of Razi Institute Jun 2020Clostridium septicum, the anaerobic toxigenic bacterium is the agent that causes dangerous disease in man and animals. There is a lethal toxin of the bacterium namely...
Clostridium septicum, the anaerobic toxigenic bacterium is the agent that causes dangerous disease in man and animals. There is a lethal toxin of the bacterium namely alpha toxin. The ɑ-toxin has hemolytic, necrotic and lethal activities. Today, Razi Vaccine and Serum Research Institute of Iran produced the C. septicum vaccine in the form of bacterin/toxoid. Because of some problems, the vaccine needs to improve on an industrial scale. The study is going to find an appropriate supplement to improve growth and ɑ-toxin production. Three strains of C. septicum (vaccine, NH1 and NH8 strains) were cultured in the basic vaccine media. Magnesium sulfate, Copper, Ferrous, yeast extract, and trace elements plus vitamins' solution were added to the basic vaccine media in different cultures. The effect of the ingredients on the growth was measured by a spectrophotometer and the α-toxin secretion was assayed by hemolysin test. Growth of the bacterium and α-toxin secretion were increased by Magnesium (80 mg/l) in NH8 and vaccine strains significantly. The black precipitate was difficult to dissolve in magnesium media that must be solved. Trace elements plus vitamins solution mildly influence on NH1strain growth and toxin secretion. Other supplements (Cu, Fe, yeast extract) were not showen any significant changes in the growth and α-toxin production of C. septicum. Overflowing peptone (4%) in the vaccine media, fixes essentials of proteolysis activity, allows the sufficient growth and toxin production without Cu, Fe, and yeast extract. Due to essentially of Mg for growth, extra magnesium was added for improvement of media culture. The study suggests for Magnesium addition in the C. septicum vaccine media during production procedure after precipitation solving problem.
Topics: Bacterial Toxins; Bacterial Vaccines; Clostridium septicum; Magnesium Sulfate
PubMed: 32621451
DOI: 10.22092/ari.2019.124567.1284 -
Anaesthesia Jan 2013Intravenous magnesium has been reported to improve postoperative pain; however, the evidence is inconsistent. The objective of this quantitative systematic review is to... (Meta-Analysis)
Meta-Analysis Review
Intravenous magnesium has been reported to improve postoperative pain; however, the evidence is inconsistent. The objective of this quantitative systematic review is to evaluate whether or not the peri-operative administration of intravenous magnesium can reduce postoperative pain. Twenty-five trials comparing magnesium with placebo were identified. Independent of the mode of administration (bolus or continuous infusion), peri-operative magnesium reduced cumulative intravenous morphine consumption by 24.4% (mean difference: 7.6 mg, 95% CI -9.5 to -5.8 mg; p < 0.00001) at 24 h postoperatively. Numeric pain scores at rest and on movement at 24 h postoperatively were reduced by 4.2 (95% CI -6.3 to -2.1; p < 0.0001) and 9.2 (95% CI -16.1 to -2.3; p = 0.009) out of 100, respectively. We conclude that peri-operative intravenous magnesium reduces opioid consumption, and to a lesser extent, pain scores, in the first 24 h postoperatively, without any reported serious adverse effects.
Topics: Acute Pain; Analgesics, Opioid; Bradycardia; Endpoint Determination; Female; Humans; Infusions, Intravenous; Injections, Intravenous; Magnesium Sulfate; Male; Morphine; Pain Measurement; Pain, Postoperative; Perioperative Care; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 23121612
DOI: 10.1111/j.1365-2044.2012.07335.x -
Anales de Pediatria Sep 2022
Topics: Anti-Asthmatic Agents; Asthma; Humans; Magnesium Sulfate
PubMed: 35907776
DOI: 10.1016/j.anpede.2022.02.004 -
Journal of Clinical Monitoring and... Aug 2023It is essential to understand the underlying pathophysiological mechanisms of preeclampsia cerebral complications. This study aimed to compare the cerebral hemodynamic... (Randomized Controlled Trial)
Randomized Controlled Trial
Evaluation of intravenous infusion of labetalol versus magnesium sulfate on cerebral hemodynamics of preeclampsia patients with severe features using transcranial doppler.
PURPOSE
It is essential to understand the underlying pathophysiological mechanisms of preeclampsia cerebral complications. This study aimed to compare the cerebral hemodynamic effects of magnesium sulfate (MgSO4) and labetalol in pre-eclampsia patients with severe features.
METHODS
Singleton pregnant women who suffered from late onset preeclampsia with severe features were enrolled and subjected to baseline Transcranial doppler (TCD) evaluation and then randomly assigned to either the magnesium sulfate group or labetalol group. TCD to measure middle cerebral artery (MCA) blood flow indices including mean flow velocity (cm/s), mean end-diastolic velocity (DIAS), and pulsatility index (PI) and to estimate CPP and MCA velocity were performed as basal measurements before study drug administration and at post-treatment one and six hours after administration. The occurrence of seizures and any adverse effects were recorded for each group.
RESULTS
Sixty preeclampsia patients with severe features were included and randomly allocated into two equal groups. In group M the PI was 0.77 ± 0.04 at baseline versus 0.66 ± 0.05 at 1hour and 0.66 ± 0.05 at 6 hours after MgSO4 administration (p value < 0.001) also the calculated CPP was significantly decreased from 103.3 ± 12.7mmHg to 87.8 ± 10.6mmHg and 89.8 ± 10.9mmHg (p value < 0.001) at 1 and 6 hours respectively. Similarly, in group L the PI was significantly decreased from 0.77 ± 0.05 at baseline to 0.67 ± 0.05 and 0.67 ± 0.06 at 1 and 6 hours (p value < 0.001) after labetalol administration. Moreover, the calculated CPP was significantly decreased from 103.6 ± 12.6 mmHg to 86.2 ± 13.02mmHg at 1 hour and to 83.7 ± 14.6mmHg at 6 hours (p value < 0.001). In terms of changes in blood pressure and the heart rate, they were significantly lower in the labetalol group.
CONCLUSION
Both magnesium sulfate and labetalol reduce CPP while maintaining cerebral blood flow (CBF) in preeclampsia patients with severe features.
TRIAL REGISTRATION
The institutional review board of the Faculty of Medicine, Zagazig University approved this study with the reference number (ZU-IRB#: 6353-23-3-2020) and it was registered at clinicaltrials.gov (NCT04539379).
Topics: Humans; Female; Pregnancy; Pre-Eclampsia; Magnesium Sulfate; Labetalol; Infusions, Intravenous; Hemodynamics; Ultrasonography, Doppler, Transcranial; Blood Flow Velocity; Cerebrovascular Circulation
PubMed: 37074522
DOI: 10.1007/s10877-023-01006-4 -
The Cochrane Database of Systematic... 2000Treatment of acute asthma is based on rapid reversal of bronchospasm and arresting airway inflammation. There is some evidence that intravenous magnesium can provide... (Review)
Review
BACKGROUND
Treatment of acute asthma is based on rapid reversal of bronchospasm and arresting airway inflammation. There is some evidence that intravenous magnesium can provide additional bronchodilation when given in conjunction with standard bronchodilating agents and corticosteroids. No systematic review of this literature has been completed on this topic.
OBJECTIVES
To examine the effect of additional intravenous magnesium sulfate in patients with acute asthma managed in the emergency department.
SEARCH STRATEGY
Randomised controlled trials were identified from the Cochrane Airways Review Group register. Bibliographies from included studies, known reviews and texts were searched. Primary authors and content experts were contacted.
SELECTION CRITERIA
Randomised controlled trials or quasi-randomised trials were eligible for inclusion. Studies were included if patients presented with acute asthma and were treated with IV magnesium sulfate vs placebo.
DATA COLLECTION AND ANALYSIS
Data were extracted and methodological quality was assessed independently by two reviewers. Missing data were obtained from authors.
MAIN RESULTS
Seven trials were included (5 adult, 2 pediatric). A total of 665 patients were involved. Patients receiving magnesium sulfate demonstrated non-significant improvements in peak expiratory flow rates when all studies were pooled (weighted mean difference: 29.4 L/min; 95% confidence interval: -3.4 to 62). In studies of people with severe acute asthma, peak expiratory flow rate improved by 52.3 L/min (95% confidence interval: 27 to 77.5). The forced expiratory volume in one second also improved by 9.8 % predicted (95% confidence interval: 3.8 to 15.8). Overall, admission to hospital was not reduced, odds ratio: 0.31 (95% confidence interval: 0.09 to 1.02). In the severe subgroup, admissions were reduced in those receiving magnesium sulfate (odds ratio: 0.10, 95% confidence interval: 0.04 to 0.27). No clinically important changes in vital signs or adverse side effects were reported.
REVIEWER'S CONCLUSIONS
Current evidence does not support routine use of intravenous magnesium sulfate in all patients with acute asthma presenting to the emergency department. Magnesium sulfate appears to be safe and beneficial in patients who present with severe acute asthma.
Topics: Acute Disease; Adrenal Cortex Hormones; Adult; Asthma; Bronchodilator Agents; Child; Drug Therapy, Combination; Emergency Service, Hospital; Humans; Infusions, Intravenous; Magnesium Sulfate
PubMed: 10796650
DOI: 10.1002/14651858.CD001490 -
Brazilian Journal of Anesthesiology... 2017Hemodynamic response to airway stimuli is a common phenomenon and its management is important to reduce the systemic repercussions. The objective of this study is to... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND AND OBJECTIVES
Hemodynamic response to airway stimuli is a common phenomenon and its management is important to reduce the systemic repercussions. The objective of this study is to compare the efficacy of intravenous magnesium sulfate versus lidocaine on this reflex hemodynamics after laryngoscopy and tracheal intubation.
METHODS
This single-center, prospective, double-blind, randomized study evaluated 56 patients ASA 1 or 2, aged 18-65 years, scheduled for elective surgeries under general anesthesia with intubation. The patients were allocated into two groups: Group F received 30mg·kg of magnesium sulphate and Group L, 2mg·kg of lidocaine, continuous infusion, immediately before the anesthetic induction. Blood pressure (BP), heart rate (HR), and bispectral index (BIS) were measured in both groups at six different times related to administration of the study drugs.
RESULTS
In both groups there was an increase in HR and BP after laryngoscopy and intubation, compared to baseline. Group M showed statistically significant increase in the values of systolic and diastolic blood pressure after intubation, which was clinically unimportant. There was no difference in the BIS values between groups. Among patients receiving magnesium sulfate, three (12%) had high blood pressure versus only one among those receiving lidocaine (4%), with no statistical difference.
CONCLUSION
Magnesium sulfate and lidocaine have good efficacy and safety for hemodynamic management in laryngoscopy and intubation.
Topics: Adolescent; Adult; Aged; Blood Pressure; Double-Blind Method; Elective Surgical Procedures; Female; Heart Rate; Hemodynamics; Humans; Infusions, Intravenous; Intubation, Intratracheal; Laryngoscopy; Lidocaine; Magnesium Sulfate; Male; Middle Aged; Prospective Studies; Treatment Outcome; Young Adult
PubMed: 28017170
DOI: 10.1016/j.bjane.2015.08.004