Key result
Perioperative intravenous lidocaine did not significantly reduce the incidence of short-term postoperative cognitive dysfunction compared to placebo after noncardiac surgery (RR 0.67, 95% CI -0.02 to 1.36, p=0.06).
Why the study?
Postoperative cognitive dysfunction is a debilitating complication, and the perioperative neuroprotective effect of lidocaine has shown conflicting results.
Does perioperative intravenous lidocaine improve short-term postoperative cognitive function in patients undergoing noncardiac surgery?
Meta-Analysis (n=326)
Does perioperative intravenous lidocaine improve short-term postoperative cognitive function in patients undergoing noncardiac surgery?
Relative Risk: 0.67 (95% CI -0.02–1.36)
p-value: p=0.06
Current evidence does not support a neuroprotective effect of perioperative intravenous lidocaine on short-term cognitive function after noncardiac surgery.
Does not support routine perioperative IV lidocaine for neuroprotection; larger RCTs needed to resolve conflicting evidence.
Objectives Postoperative cognitive dysfunction is a debilitating postoperative complication. The perioperative neuroprotective effect of lidocaine has conflicting results. Methods In this qualitative review of randomized controlled clinical trials on the perioperative use of lidocaine, we report the effects of intravenous lidocaine on brain function after noncardiac surgery. Studies were identified from PubMed, MEDLINE, and Cochrane Central Register. Results Of the 453 retrieved studies, 4 randomized trials were included. No significant association between the use of lidocaine postoperative cognitive states was found (risk ratio 0.67; 95% CI −0.02 to 1.36; I289%; p = .06). Conclusions Current evidence cannot suggest that perioperative intravenous use of lidocaine has pharmacological brain neuroprotection after noncardiac surgery. All the included studies were small‐scale research, and the total number of participants was small; the results should be interpreted with caution.
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Huang et al. (2020) conducted a meta-analysis in Postoperative cognitive dysfunction (POCD) (n=326). Intravenous lidocaine vs. Placebo or normal saline was evaluated on Incidence of short-term postoperative cognitive dysfunction (risk ratio 0.67, 95% CI -0.02 to 1.36, p=0.06). Perioperative intravenous lidocaine did not significantly reduce the incidence of short-term postoperative cognitive dysfunction compared to placebo after noncardiac surgery (RR 0.67, 95% CI -0.02 to 1.36, p=0.06).
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