Lidocaine and Neurologic Outcomes after Cardiac Surgery

50% of cardiac surgery patients leave hospital with cognitive dysfunction which tends to improve but may persist at 5 years in some. Based on previous suggestion that Lidocaine may ameliorate such issues due to postulated anti-inflammatory, blood flow, and cerebral metabolism mechanisms, this randomized study failed to find benefit with use of Lidocaine infusion during and for 48 hours after cardiac surgeries.

Conclusion: Intravenous lidocaine administered during and after cardiac surgery did not reduce postoperative cognitive decline at 6 weeks.

The authors note the complex issues involved in cognitive dysfunction that could not be expected to benefit from a single agents – preoperative cognitive impairment, genetic predisposition, cerebral microembolism or hypoperfusion during CPB, inflammatory responses, hemodilution, hyperglycemia, hyperthermia, unmasking of Alzheimer disease, and acceleration of amyloid deposition associated with inhalational anesthetics.

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