Lidocaine administration before tracheal extubation cannot reduce post-operative cognition disorders in elderly patients


Department of Anesthesiology and Intensive Care, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Cognitive dysfunction after surgery is common in elderly patients. Many factors such as anesthetic drugs can cause complication in this surgery. Lidocaine is one of the drugs commonly used during anesthesia. So, we designed this study to find out cognitive effect of lidocaine in elderly patients undergoing non-cardiac surgeries.
Materials and Methods: In this double-blinded clinical trial, we enrolled 70 patients older than 65 years age undergoing urologic or orthopedic surgeries, were divided in two groups. Patients randomly received intravenous lidocaine (1.5 mg/kg) or normal saline in the same volume immediately before extubation. Mini mental state examination (MMSE) test was used to evaluate cognitive state at discharge time, 6 and 24 h after surgery.
Results: Mean MMSE scores at the time of discharge from recovery room in lidocaine and saline groups were 22.4 ± 4.5 vs. 22.1 ± 4.4, P = 0.755, respectively. It was significantly lower than MMSE before surgery, 6 and 24 h after the operation. The mean MMSE scores and frequency distribution of intensity of cognitive impairments were not significantly different between two groups at different times.
Conclusion: Bolus intravenous lidocaine before extubation, did not affect cognitive states in elders undergoing non-cardiac surgery. Effect of lidocaine on cardiac surgeries is clear, but in non-cardiac surgeries, lidocaine has no clinical effects. So, more studies with different doses of lidocaine and different assessment methods are recommended.


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