Neuroprotective Effects of Intravenous Lidocaine on Early Postoperative Cognitive Dysfunction in Elderly Patients Following Spine Surgery

作者：Chen Kui; Wei Penghui; Zheng Qiang; Zhou Jinfeng; Li Jianjun^*

来源：MEDICAL SCIENCE MONITOR, 2015, 21: 1402-1407.

DOI：10.12659/msm.894384

• Cognition
• Lidocaine
• Postoperative Complications

Background: 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/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-alpha, MDA, S100b, 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, S100b, 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.

• 出版日期2015-5-15
• 单位山东大学