Effect of local anesthesia (with lidocaine vs bupivacaine) on cognitive function in patients undergoing elective cataract surgery

Abstract

Purpose

Postoperative cognitive dysfunction has gained much attention over the last years. Multiple clinical trials have attempted to differentiate the effect of local vs general anesthesia on postoperative cognitive function. The aim of this work was to study the effect of local anesthesia with lidocaine vs bupivacaine on cognitive function

Patients and methods

This was a prospective randomized trial carried out on 61 patients undergoing elective cataract surgery by phacoemulsification under local anesthesia. Twenty-eight patients received lidocaine 2% and 33 patients received bupivacaine 0.5%. Cognitive assessment for all patients was done preoperatively and 1 week postoperatively using paired associate learning test (PALT) and category verbal fluency (VF) test (animal category).

Results

Regarding cognitive assessment of patients in lidocaine group, there was a statistically significant difference between the mean value of preoperative PALT and postoperative PALT (P-value =0.004), and between the mean value of preoperative VF and postoperative VF (P-value =0.002). As for bupivacaine group, there was a statistically significant difference between the mean value of preoperative PALT and postoperative PALT (P-value =0.021), and between the mean value of preoperative VF and postoperative VF (P-value =0.037). On comparing lidocaine and bupivacaine groups in pre and postoperative PALT & VF scores, there was no statistically significant difference between both groups

Conclusion

Both lidocaine and bupivacaine caused postoperative cognitive impairment. Lidocaine was found to have a worse effect on cognitive function than bupivacaine, but the difference was not statistically significant.

Keywords:

• lidocaine
• bupivacaine
• cataract
• PALT
• VF

Acknowledgments

The authors did not receive any funding for this work. The abstract of this paper was presented at Euroanaesthesia congress 2018 (Copenhagen, Denmark, 2–4 June 2018) at Bella Center as a poster presentation. The session date was 3 June 2018, and the session time was 10:15–11:45. The poster’s abstract was published in “Poster Abstracts” in the e-Supplement of the European Journal of Anaesthesiology (Volume 35, Supplement 56).

Author contributions

WF participated in study conception and design, sequence alignment, and helped to draft the manuscript. HK participated in collection and analysis of data and helped to draft the manuscript. MH participated in collection of data, data analysis, and helped to draft the manuscript. All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.