Monday, January 4, 2010

NASCIS III Protocol :SCI treatment

Treatment of Acute Spinal Cord Injury:
Methylprednisolone: Bolus dose of 30 mg/kg of body weight over 15 minutes, followed by a 45-minute pause, and then a 23-hour continuous infusion of 5.4 mg/kg/hr. (Bracken Regime or NASCIS II PROTOCOL).
In the NASCIS III protocol,
*    The dose mentioned in NASCIS 2 for 24 h if patient presents <3 h after injury
*    If patient presents between 3 and 8 h, give the above steroid infusion for total of 48 h
*    Tirilizad mesylate (an antioxidant) has a similar effect to that of steroids if given in hyper acute phase

Newer agents: GM-1 ganglioside, naloxone (an opiate antagonist), and monosialganglioside.

*    They are glycosphingolipids at outer cellular membranes at the central nervous system
*    gangliosides may have a neuroprotection action, with more speedy recovery of motor and sensory function in partial cord injuries