A Comparative Study Between Laryngeal Mask Airway and Magensium Sulphate in Attenuating Systemic Stress Response During Emergence of Patients Undergoing Supratentorial Tumours.
Condition: LMA Versus Mgso4 in Attenuating Stress Response During Emergence of Supratentorial Tumours Patients
MeSH terms: Supratentorial Neoplasms
Study type: Interventional

Summary: 
      To evaluate the efficacy of replacement of ETT with LMA and administration of Magnesium
      sulphate at the end of the surgery in attenuating systemic stress response during emergence
      of patients undergoing supratentorial tumours
    

Detailed description: 
      Rapid recovery from neuroanesthesia and early neurological examination are desirable in most
      cases.(1)Although, Systemic and cerebral hemodynamic changes caused by extubation and
      emergence from anesthesia may endanger neurosurgical patients and increase the risk of
      postoperative intracranial hemorrhage and cerebral edema and may even result in the
      requirement of reoperation.(2) During this phase, heart rate and arterial blood pressure
      increase leading to increases in cerebral blood flow and intracranial pressure.(3) Some
      studies have reported such hemodynamic effects in up to 50% of patients after supratentorial
      craniotomy.(4,5) Replacing the endotracheal tube (ETT) with laryngeal mask airway (LMA) prior
      to emergence from anesthesia is safe and effectively reduces the cardiovascular response.(6)
      The potential protective benefit of this approach has not yet been demonstrated for awakening
      neurosurgery patients, however.

      Magnesium is the forth most abundant cation in the body and the second most abundant
      intracellular cation. It activates many of the enzyme systems.(7) Magnesium sulphate inhibits
      catecholamines release from adrenergic nerve terminals and from adrenal medulla, through
      blocking N-type of Ca-channel at peripheral sympathetic nerve ending so it is used to
      decrease the adverse cardiovascular effects during larygeoscopy and endotracheal
      intubation.(8) But its role in attenuating stress response during extubation is not well
      studied and need more research.
    

Intervention name(s): Laryngeal mask airway; Magensium sulphate; Control group (closure of anesthetics)
Intervention type(s): Device; Drug; Other
Intervention description(s): After obtaining approval of the ethics committee of Kasr Al Ainy Hospitals and informed written consents from the patients, this study will be performed on 20 patients in Kasr Al Ainy Hospitals with ASA physical status I, II and ages between 18 and 60 years undergoing undergoing supratentorial tumours excision under general anesthesia; After obtaining approval of the ethics committee of Kasr Al Ainy Hospitals and informed written consents from the patients, this study will be performed on 20 patients in Kasr Al Ainy Hospitals with ASA physical status I, II and ages between 18 and 60 years undergoing undergoing supratentorial tumours excision under general anesthesia; After obtaining approval of the ethics committee of Kasr Al Ainy Hospitals and informed written consents from the patients, this study will be performed on 20 patients in Kasr Al Ainy Hospitals with ASA physical status I, II and ages between 18 and 60 years undergoing undergoing supratentorial tumours excision under general anesthesia
Intervention MeSH terms: Anesthetics
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: We hypothesize that the LMA is more effective than Magnesium sulphate in attenuating systemic stress response during emergence of patients undergoing supratentorial tumours
Masking: Double (Participant, Care Provider)
Primary purpose: Supportive Care