Neuroprotective Effects of Intravenous Lidocaine on Early Postoperative Cognitive Dysfunction in Elderly Patients Following Spine Surgery
Kui Chen, Penghui Wei, Qiang Zheng, Jinfeng Zhou, Jianjun Li
(Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, Shandong, China (mainland))
Med Sci Monit 2015; 21:1402-1407
This study aimed to evaluate the effects of lidocaine treatment on cognitive impairment in aged patients undergoing spine surgery and to explore the underlying mechanism.
MATERIAL AND METHODS: Patients were randomly divided into 2 treatment groups: (1) saline (control) and (2) lidocaine. After induction of anesthesia, the lidocaine group received lidocaine as a bolus of 1 mg/kg over 5 minutes, followed by a continuous infusion at 1.5 mg/kg/h until the end of the surgery. We examined the effects of lidocaine treatment on the improvement of cognitive function using the Mini-Mental State Examination (MMSE) at preoperation and 3 days postoperation. Serum samples were collected to assess the levels of IL-6, TNF-α, MDA, S100β, and NSE before inducing anesthesia, at the end of surgery, and 3 days after the end of surgery.
RESULTS: We found that the MMSE scores in the lidocaine group were markedly higher than those in the control group at 3 days after surgery. Moreover, lidocaine treatment markedly suppressed the release of IL-6, S100β, and NSE into the serum at the end of surgery and 3 days after the end of surgery. In the control group, serum MDA levels increased by 3 days after the end of surgery. The lidocaine group had lower serum MDA levels than those in the control group.
CONCLUSIONS: Lidocaine may be an effective neuroprotective agent in treating early postoperative cognitive dysfunction in elderly patients undergoing spine surgery.
Keywords: Aged, 80 and over, Aged, Anesthesia, General, Cognition Disorders - prevention & control, Female, Humans, Infusions, Intravenous, Interleukin-6 - blood, Lidocaine - therapeutic use, Male, Malondialdehyde - blood, Neuroprotective Agents - therapeutic use, Neuropsychological Tests, Neurosurgery, Phosphopyruvate Hydratase - blood, Postoperative Complications - prevention & control, S100 Calcium Binding Protein beta Subunit - blood, Single-Blind Method, Spine - surgery, Tumor Necrosis Factor-alpha - analysis