A Comparison of the Effect of Intravenous Dexamethasone and Lidocaine on Prevention of Postoperative Cognitive Disorders in Cataract Surgery in Elderly Patients

Document Type : Original Article (s)

Authors

1 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Postoperative cognitive disorder is one of the most common complications after surgery especially in the elderly population, of which delirium is the most important. This complication may cause changes in personality and memory of patients, and increase postoperative complications. In this study, we decided to compare the preventative effects of intravenous administration of dexamethasone and lidocaine on postoperative cognitive disorder after cataract surgery in the elderly.Methods: In this double-blind clinical trial study with control group, 333 patients above 65 years of age were divided randomly into three groups receiving lidocaine, dexamethasone, and placebo. The cognitive scores before and after the surgery were compared between the groups.Findings: In the three groups receiving lidocaine, dexamethasone, and placebo, 6.4%, 3.6%, and 5.3% had cognitive disorder prior to surgery, respectively, which had no significant difference (P = 0.62). The prevalence of the postoperative cognitive disorders in the three groups of lidocaine, dexamethasone, and placebo was 12.0%, 9.9%, and 6.9%, respectively, which was not significantly different either (P = 0.98). The prevalence of cognitive disorders after one week in the three groups of lidocaine, dexamethasone, and placebo was 3.8%, 1.8%, and 8.8%, respectively, which was not significantly different (P = 0.98).Conclusion: The administration of lidocaine or dexamethasone had no significant effect in reducing postoperative cognitive disorder, but since the use of dexamethasone is limited in patients with cataract undergoing surgery due to various underlying medical conditions, using lidocaine is preferable in such patients.

Keywords

References

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Journal of Isfahan Medical School
Volume 36, Issue 484 - Serial Number 484
May and June 2018
Pages 666-672

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History

  • Receive Date: 20 April 2018
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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