Randomized Placebo-Controlled Study to Evaluate the Effect of Magnesium Sulfate on Intraoperative Neuromonitoring

What this Trial Is About

Researchers are evaluating the effect of magnesium sulfate on intraoperative neuromonitoring (IONM) during complex spine and cranial surgeries. This study aims to understand how magnesium sulfate influences the amplitude and latency of somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs). Magnesium sulfate is used in multimodal pain management during surgery, but its impact on IONM, which helps monitor neural pathways in real-time to prevent injury, has not been studied before. The study is a double-blind, randomized, placebo-controlled trial comparing a magnesium sulfate bolus and infusion to a saline placebo. Participants undergoing surgery with planned IONM will receive a 40 mg/kg magnesium sulfate bolus over 10 minutes followed by a continuous infusion, or a saline bolus over 10 minutes. Anesthesia will be maintained with propofol and remifentanil. Baseline and repeated measurements of SSEPs and MEPs will be recorded before and after drug administration at specific time points up to 30 minutes. Participants will be monitored continuously during surgery with standard anesthesia and brain function monitors. Hemodynamic data will be collected every five minutes up to 30 minutes after drug administration. Researchers will compare changes in the amplitude and latency of SSEPs and MEPs to assess magnesium sulfate's effects on IONM. The trial lasts through the surgery and immediate monitoring period. Safety and neurological function will be closely observed throughout.

Effect of Magnesium Sulfate Bolus on Intraoperative Neuromonitoring