Abstract | BACKGROUND AND PURPOSE: METHODS: After IRB approval, 277 patients undergoing cardiac surgery were enrolled into this prospective, randomized, double-blinded placebo controlled clinical trial. Subjects were randomized to receive: (1) Lidocaine as a 1 mg/kg bolus followed by a continuous infusion through 48 hours postoperatively, or (2) Placebo bolus and infusion. Cognitive function was assessed preoperatively and again at 6 weeks and 1 year postoperatively. The effect of lidocaine on postoperative cognition was tested using multivariable regression modeling; P<0.05 was considered significant. RESULTS: Among the 241 allocated subjects ( Lidocaine: n=114; Placebo: n=127), the incidence of cognitive deficit in the lidocaine group was 45.5% versus 45.7% in the placebo group (P=0.97). Multivariable analysis revealed a significant interaction between treatment group and diabetes, such that diabetic subjects receiving lidocaine were more likely to suffer cognitive decline (P=0.004). Secondary analysis identified total lidocaine dose (mg/kg) as a significant predictor of cognitive decline and also revealed a protective effect of lower dose lidocaine in nondiabetic subjects. CONCLUSIONS:
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Authors | Joseph P Mathew, G Burkhard Mackensen, Barbara Phillips-Bute, Hilary P Grocott, Donald D Glower, Daniel T Laskowitz, James A Blumenthal, Mark F Newman, Neurologic Outcome Research Group (NORG) of the Duke Heart Center |
Journal | Stroke
(Stroke)
Vol. 40
Issue 3
Pg. 880-7
(Mar 2009)
ISSN: 1524-4628 [Electronic] United States |
PMID | 19164788
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anesthetics, Local
- Inflammation Mediators
- Neuroprotective Agents
- Lidocaine
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Topics |
- Aged
- Anesthesia
- Anesthetics, Local
(therapeutic use)
- Cardiac Surgical Procedures
(adverse effects)
- Cognition Disorders
(prevention & control, psychology)
- Double-Blind Method
- Female
- Follow-Up Studies
- Humans
- Inflammation
(prevention & control)
- Inflammation Mediators
(blood)
- Intelligence Tests
- Lidocaine
(therapeutic use)
- Male
- Memory
- Middle Aged
- Neuroprotective Agents
(therapeutic use)
- Neuropsychological Tests
- Postoperative Complications
(prevention & control, psychology)
- Psychomotor Performance
(physiology)
- Regression Analysis
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