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Cited by 2,715

The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.

A Randomized, Controlled Trial of Methylprednisolone or Naloxone in the Treatment of Acute Spinal-Cord Injury: Results of the Second National Acute Spinal Cord Injury Study

Open access
Bracken, Michael B., Shepard, Mary Jo, Collins, William F., Holford, Theodore R., Young, Wise, Baskin, David S., Eisenberg, Howard M., Flamm, Eugene, Leo-Summers, Linda, Maroon, Joseph, Marshall, Lawrence F., Perot, Phanor L., Piepmeier, Joseph, Sonntag, Volker K.H., Wagner, Franklin C., Wilberger, Jack E., Winn, H. Richard·1990·New England Journal of Medicine
DOI 10.1056/nejm199005173222001
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Abstract

Studies in animals indicate that methylprednisolone and naloxone are both potentially beneficial in acute spinal-cord injury, but whether any treatment is clinically effective remains uncertain. We evaluated the efficacy and safety of methylprednisolone and naloxone in a multicenter randomized, double-blind, placebo-controlled trial in patients with acute spinal-cord injury, 95 percent of whom were treated within 14 hours of injury. Methylprednisolone was given to 162 patients as a bolus of 30 mg per kilogram of body weight, followed by infusion at 5.4 mg per kilogram per hour for 23 hours. Naloxone was given to 154 patients as a bolus of 5.4 mg per kilogram, followed by infusion at 4.0 mg per kilogram per hour for 23 hours. Placebos were given to 171 patients by bolus and infusion. Motor and sensory functions were assessed by systematic neurological examination on admission and six weeks and six months after injury. After six months the patients who were treated with methylprednisolone within eight hours of their injury had significant improvement as compared with those given placebo in motor function (neurologic change scores of 16.0 and 11.2, respectively; P = 0.03) and sensation to pinprick (change scores of 11.4 and 6.6; P = 0.02) and touch (change scores, 8.9 and 4.3; P = 0.03). Benefit from methylprednisolone was seen in patients whose injuries were initially evaluated as neurologically complete, as well as in those believed to have incomplete lesions. The patients treated with naloxone, or with methylprednisolone more than eight hours after their injury, did not differ in their neurologic outcomes from those given placebo. Mortality and major morbidity were similar in all three groups. We conclude that in patients with acute spinal-cord injury, treatment with methylprednisolone in the dose used in this study improves neurologic recovery when the medication is given in the first eight hours. We also conclude that treatment with naloxone in the dose used in this study does not improve neurologic recovery after acute spinal-cord injury.

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Crossref · 10.1056/nejm199005173222001

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Metadata

Authors
Bracken, M. B., Shepard, M. J., Collins, W. F., Holford, T. R., Young, W., Baskin, D. S., Eisenberg, H. M., Flamm, E., Leo-Summers, L., Maroon, J., Marshall, L. F., Perot, P. L., Piepmeier, J., Sonntag, V. K. H., Wagner, F. C., Wilberger, J. E., & Winn, H. R.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1990-05-17
Volume
322
Issue
20
Pages
1405-1411
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199005173222001
OpenAlex
W2797732082
Cited by
2,715
References
3
FWCI
74.49
Type
journal article
Language
en
Open access
bronze

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