Patient develops myelopathy post trauma. What dose of methyl prednisolone is to be given:
Ans is 'a' i.e. 30 mg/kg within 3 hrs Methylprednisolone has got potent antiinflammatory properties and thus has been used for the treatment of acute spinal cord injury. Some sensory and motor improvements have been reported when methylprednisolone is administered within 8 hours after spinal cord injury.Methylprednisolone infused 8 hours or more after injury seemed to be of no benefitThe National Spinal Cord Injury Study (NASCIS) has conducted three trials I, II and III on early high dose steroids after spinal cord injury. Acute steroid therapy is believed to reduce the cellular damage resulting from secondary injury processes such as lipid peroxidation.Recommended protocol for acute spinal cord injury is:30 mg/kg bolus within 8 hrs of injury followed by twenty three hours of infusion at 5.4 mg/kg per hourHigh dose of steroids has its associated side effects such as increased incidence of wound infection and gastrointestinal hemorrhage.It must also be mentioned that the use of high dose steroids after acute spinal cord injury is highly controversial and has been refuted by many authors.
30 mg/kg within 3 hrs
45 mg/kg within 6 hrs
60 mg/i:g within 9 hrs
75 mg/kg within 12 hrs
Management In Orthopedics