title: Neuroprotective effects of intravenous lidocaine on early postoperative cognitive dysfunction in elderly patients following spine surgery.
abstract: 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.
  
  
  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.
authors.affiliation: Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, Shandong, China (mainland).
authors.forename: Kui
authors.initials: K
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, Shandong, China (mainland).
authors.forename: Penghui
authors.initials: P
authors.lastname: Wei
authors.affiliation: Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, Shandong, China (mainland).
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zheng
authors.affiliation: Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, Shandong, China (mainland).
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, Shandong, China (mainland).
authors.forename: Jianjun
authors.initials: J
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D003072:Cognition Disorders / Q000097:blood / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D015850:Interleukin-6 / Q000097:blood; D008012:Lidocaine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D018696:Neuroprotective Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D009483:Neuropsychological Tests; D009493:Neurosurgery; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011183:Postoperative Complications / Q000097:blood / Q000517:prevention & control*; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood; D016037:Single-Blind Method; D013131:Spine / Q000601:surgery*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D018696:Neuroprotective Agents; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human; D014409:Tumor Necrosis Factor-alpha; D008315:Malondialdehyde; D008012:Lidocaine; D010751:Phosphopyruvate Hydratase