Newly Published
Correspondence  |   November 2019
Intravenous Lidocaine and Postoperative Cognition: Comment
Author Notes
  • West China Hospital, Sichuan University, People’s Republic of China (T.Z.). xwtao_zhu@yahoo.com
  • Accepted for publication October 4, 2019.
    Accepted for publication October 4, 2019.×
Article Information
Correspondence
Correspondence   |   November 2019
Intravenous Lidocaine and Postoperative Cognition: Comment
Anesthesiology Newly Published on November 13, 2019. doi:https://doi.org/10.1097/ALN.0000000000003039
Anesthesiology Newly Published on November 13, 2019. doi:https://doi.org/10.1097/ALN.0000000000003039
We read with great interest the article by Klinger et al.1  regarding the effect of intravenous lidocaine on neurologic outcomes after cardiac surgery. We appreciate and congratulate the authors for setting up a clearly structured randomized trial with a large sample size and sharing such useful findings. There are, however, two important points of concern.
First, patients with hypertension are believed to be more susceptible to cerebral hypoperfusion resulting from inappropriate blood pressure and impaired autoregulation of cerebral blood flow while underdoing cardiac surgeries, and cerebral hypoperfusion has been considered an important risk factor contributing to postoperative cognitive dysfunction.2  In this trial, participants with hypertension made up a sizeable proportion (59% in lidocaine group vs. 61.2% in placebo group; P = 0.268) of the overall population, the authors used the common practice of maintaining mean arterial pressure from 50 to 80 mmHg through cardiopulmonary bypass, but it was not mentioned whether there were differences in the mean arterial pressures, the durations of intraoperative hypotension, the durations of cerebral desaturation, or any other data that could suggest cerebral perfusion between the two groups.