Key result
Perioperative administration of lidocaine in patients undergoing cardiac surgery significantly reduced the occurrence of cognitive deficit (OR 0.583; 95% CI 0.438-0.777; P=0.00).
Why the study?
Does perioperative administration of lidocaine reduce the occurrence of cognitive deficit in patients undergoing coronary artery bypass grafting and valve plasty?
Meta-Analysis (n=688)
Does perioperative administration of lidocaine reduce the occurrence of cognitive deficit in patients undergoing coronary artery bypass grafting and valve plasty?
Odds Ratio: 0.583 (95% CI 0.438–0.777)
p-value: p=0.00
Perioperative administration of lidocaine significantly reduces the occurrence of cognitive deficit in patients undergoing CABG and valve plasty.
Supports perioperative lidocaine to reduce cognitive deficits after cardiac surgery; reinforces meta-analytic evidence for its use.
Introduction: The administration of lidocaine to maintain cognitive function following coronary artery bypass grafting (CABG) and valve plasty is a controversial concept in terms of its effectiveness. We performed a systematic review to determine the effectiveness of treatment with lidocaine in preventing the occurrence of cognitive deficit after cardiac surgery.Area covered: To review the current literature on the subject, we searched the PubMed database and the Cochrane Library database (up to May 2015) and compiled a list of retrieved articles. Our final review includes only randomized controlled trials (RCTs) that compared lidocaine to a control (placebo) following CABG and valve plasty. Statistical analysis of the odds ratio (OR) and corresponding 95% confidence interval (CI) were used to determine the overall effectiveness of lidocaine for the prevention of cognitive deficit with both procedures. The Mantel–Haenszel method was used to pool data of the outcomes of cognitive deficit occurrence into fixed-effect model meta-analyses. Five RCTs were included in this study, with a total of 688 patients. Perioperative administration of lidocaine in patients undergoing cardiac surgery reduced occurrence of cognitive deficit (OR 0.583 [95% CI 0.438–0.777]; Z = -3.680; P = 0.00; I2 = 52%). No significant difference in the early occurrence of cognitive deficit was revealed in patients after cardiac surgery (OR 0.909 [95% CI 0.600–1.376]; Z = -0.451; P = 0.652; I2 = 11%).Expert commentary: Cognitive deficit associated with cardiac surgery is a common postoperative event. Lidocaine is contributed to a significantly reduced occurrence of cognitive deficit. Cognitive deficit management is recommended.
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Baradari et al. (2016) conducted a meta-analysis in Coronary artery bypass grafting and valve plasty (n=688). Lidocaine vs. Placebo was evaluated on Occurrence of cognitive deficit (OR 0.583, 95% CI 0.438-0.777, p=0.00). Perioperative administration of lidocaine in patients undergoing cardiac surgery significantly reduced the occurrence of cognitive deficit (OR 0.583; 95% CI 0.438-0.777; P=0.00).
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