Can lidocaine protect against cerebral dysfunction of patients with cardiopulmonary bypass surgery?

ABSTRACT

The objective of this study was to investigate whether intraoperative administration of lidocaine can reduce the incidence of cerebral dysfunction in patients undergoing cardiac surgery with cardiopulmonary bypass [CPB]. 60 patients scheduled for cardiac surgery with CPB enrolled randomly into 2 groups control group and lidocaine group. They were subjected to the same methods of anesthesia, monitoring process and CPB, and myocardial preservation techniques, lidocaine group received of 2 mg/kg bolus over 5 minutes and then infusion of 4 mg/min until the end of operation. The control group received normal saline at the same volume, rate and time. A brief battery of neuropsychologic tests was obtained preoperatively and on the tenth postoperative day. Jugular bulb oxygen [SJVO[2]] and S100beta protein were determined at different measuring points. The incidence of postoperative cognitive decline was significantly less in lidocaine group. SJVO[2] was significantly reduced during rewarming, only in the control group. S100beta was significantly elevated 24hs after CPB in both groups. The elevation was more significant in the control group. The cognitively declined patients tended to have significant fewer years of education, significant longer cross clamp time, longer CPB time, longer time to recovery and to extubation and higher S100beta. S100beta 24 hours after the bypass, was found in significant correlation with aortic cross clamp time, CPB time, time to recovery and to extubation, besides performance in Rey AVLT and Trial Making tests. We can conclude that lidocaine has a protective effect against cerebral insult of CPB