Lignocaine: Neuro-protective or Wishful Thinking?

Overview

Journal J Extra Corpor Technol

Publisher EDP Sciences

Specialties Biotechnology
General Surgery
Health Services

Date 2009 Apr 14

PMID 19361040

Citations 4

Authors

Simon J Mitchell

Alan F Merry

Affiliations

Soon will be listed here.

Abstract

Peri-operative brain injury continues to occur in cardiac surgery despite a significant effort in preventative research spanning 50 years. There has been much interest in pharmacologic neuro-protection. Six drugs, thiopentone, prostacyclin, nimodipine, remacemide, lignocaine, and Glypromate, have been the subject of one or more randomized controlled trials (RCTs). Only the results for Glypromate are unknown at this stage. In all other cases, the studies have been negative, equivocal, or initially positive but followed by negative studies. Lignocaine is arguably the most extensively studied. In vitro and in vivo experiments that proved lignocaine to be neuro-protective were followed by two RCTs that showed reductions in post-operative cognitive deficits. However, two further RCTs have failed to demonstrate benefit. Lignocaine cannot be recommended for neuro-protection in cardiac surgery at this time, but a role in clinical neuro-protection in this or other contexts is not ruled out.

Citing Articles

Concise Overview of Glypromate Neuropeptide Research: From Chemistry to Pharmacological Applications in Neurosciences.

Silva-Reis S, Sampaio-Dias I, Costa V, Correia X, Costa-Almeida H, Garcia-Mera X ACS Chem Neurosci. 2023; 14(4):554-572.

PMID: 36735764 PMC: 9936549. DOI: 10.1021/acschemneuro.2c00675.

Protective role of lidocaine against cerebral ischemia-reperfusion injury: An study.

Lan X, Xu Y Exp Ther Med. 2021; 23(1):42.

PMID: 34849157 PMC: 8613535. DOI: 10.3892/etm.2021.10964.

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial.

Klinger R, Cooter M, Bisanar T, Terrando N, Berger M, Podgoreanu M Anesthesiology. 2019; 130(6):958-970.

PMID: 30870159 PMC: 6520120. DOI: 10.1097/ALN.0000000000002668.

Cardiac surgery, the brain, and inflammation.

Scott D, Evered L, Silbert B J Extra Corpor Technol. 2014; 46(1):15-22.

PMID: 24779114 PMC: 4557505.

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