A comparison of the effect of intravenous dexamethasone and lidocaine on prevention of postoperative cognitive disorders in cataract surgery in elderly patients

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. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved.