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.

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, Anesthesia, General, Cognition Disorders - prevention & control, Infusions, Intravenous, Interleukin-6 - blood, Lidocaine - therapeutic use, 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