title: Lidocaine administration before tracheal extubation cannot reduce post-operative cognition disorders in elderly patients.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Anesthesiology and Intensive Care, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Sayed Jalal
authors: SJ
authors: Hashemi
authors: Department of Anesthesiology and Intensive Care, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Sayed Morteza
authors: SM
authors: Heidari
authors: Department of Anesthesiology and Intensive Care, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Azadeh
authors: A
authors: Rahavi
keywords: Cognitive dysfunction; elderly patients; lidocaine; post-operative