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Cognitive deficit in first-time coronary artery bypass graft patients: A randomized clinical trial of lidocaine versus procaine hydrochloride

Ghafari, R. and Baradari, A.G. and Firouzian, A. and Nouraei, M. and Aarabi, M. and Zamani, A. and Zeydi, A.E. (2012) Cognitive deficit in first-time coronary artery bypass graft patients: A randomized clinical trial of lidocaine versus procaine hydrochloride. Perfusion (United Kingdom), 27 (4). pp. 320-325. ISSN 02676591 (ISSN)

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Abstract

Introduction: Cognitive dysfunction increasingly has been recognized as a complication after cardiac surgery. Different methods have been considered for the reduction of cognitive dysfunction after cardiac surgery. One of these methods is by using lidocaine during surgery. The aim of this study was to determine the effects of adding lidocaine to the cardioplegia solution on cognitive impairment after coronary artery surgery. Design and methods: In a prospective, randomized, double-blind trial, 110 patients aged between 20-70 years, scheduled for elective CABG surgery using cardiopulmonary bypass, were recruited into the study. They were randomized into two groups who received either cardioplegia solution containing lidocaine 2 mg/kg or procaine hydrochloride 5 mg/kg. The neurocognitive test used in this study was the Mini Mental State Examination (MMSE) or Folstein test. The test was done on the day before and 10 days and 2 months after the operation. Results: In the procaine group, the total score after 10 days decreased significantly compared to the preoperative score (mean difference 0.68; 95% CI: 0.20 to 1.17, p=0.006). Comparison between mean differences after 10 and 60 days of operation between the lidocaine and procaine groups were statistically significant, p-value 0.017 and 0.013, respectively. There was no cognitive impairment in the lidocaine group, but, in the procaine group, four patients (7.7%) after 10 days and one patient (1.9%) after both 10 and 60 days had cognitive impairment, p=0.051. Conclusions: Administration of lidocaine compared to that of procaine through the cardioplegia solution had a better effect on cognitive function after coronary artery bypass graft surgery. © The Author(s) 2012.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Perfusion [Field not mapped to EPrints] C2 - 22588946 [Field not mapped to EPrints] AD - Department of Cardiac Surgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran [Field not mapped to EPrints] AD - Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran [Field not mapped to EPrints] AD - Department of Epidemiology, Cardiovascular Research Center, Golestan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] AD - Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: CABG, cardioplegic solution, cognitive function, lidocaine, procaine hydrochloride, cardioplegic agent, lidocaine, procaine, adult, aged, article, cardiopulmonary bypass, cognition, cognitive defect, controlled study, coronary artery bypass graft, double blind procedure, female, human, major clinical study, male, mini mental state examination, neuroprotection, preoperative period, priority journal, randomized controlled trial, Adult, Aged, Anesthetics, Local, Cardioplegic Solutions, Cognition, Coronary Artery Bypass, Double-Blind Method, Female, Humans, Lidocaine, Male, Middle Aged, Procaine, Time Factors
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 20 Apr 2015 09:01
Last Modified: 19 May 2015 04:32
URI: http://eprints.goums.ac.ir/id/eprint/1993

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