Evidence map›Paper›PMID 38282502›Full record

Trial reportAnaesthesiology intensive therapy2023

Comparative evaluation of intraoperative dexmedetomidine versus lidocaine for reducing postoperative cognitive decline in the elderly: a prospective randomized controlled trial.

Mahendran T Kurup, Soumya Sarkar, Rohit Verma, Renu Bhatia, Puneet Khanna, Souvik Maitra, Rahul Anand, Bikash R Ray, Akhil K Singh, K K Deepak

Open access · diamondAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Anaesthesiology intensive therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Observational
  4. Article
  5. Remimazolam: a comprehensive review.Anaesthesiology intensive therapy · 2025
    Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Mahendran T KurupDepartment of Anaesthesia, Pain Medicine & Critical Care, AIIMS, New Delhi, India.
Soumya SarkarDepartment of Anesthesiology, AIIMS, Kalyani, India.
Rohit VermaDepartment of Psychiatry, AIIMS, New Delhi.
Renu BhatiaDepartment of Physiology, AIIMS, New Delhi, India India.
Puneet KhannaDepartment of Anaesthesia, Pain Medicine & Critical Care, AIIMS, New Delhi, India.
Souvik MaitraDepartment of Anaesthesia, Pain Medicine & Critical Care, AIIMS, New Delhi, India.
Rahul AnandDepartment of Anaesthesia, Pain Medicine & Critical Care, AIIMS, New Delhi, India.
Bikash R RayDepartment of Anaesthesia, Pain Medicine & Critical Care, AIIMS, New Delhi, India.
Akhil K SinghDepartment of Anaesthesia, Pain Medicine & Critical Care, AIIMS, New Delhi, India.
K K DeepakDepartment of Physiology, AIIMS, New Delhi, India India.
All India Institute of Medical Sciences · INAll India Institute of Medical Sciences Raipur · INAll India Institute of Medical Sciences Bhopal · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNeuroinflammation, neuronal cytotoxicity, and apoptosis due to exposure to anaesthetic agents are often implicated in postoperative cognitive dysfunction (POCD). Lidocaine and dexmedetomidine have been shown to suppress the neuron-specific markers of inflammation, and we aimed to compare their neuroprotective efficacy in elderly patients. MATERIAL AND

methodsThis prospective randomized control study compared the incidence of POCD in ASA I/II patients aged 60 to 80 years without any history of substance abuse or any disorder affecting cognition. Dexmedetomidine and lidocaine were administered intraoperatively, and their effects on POCD were correlated with serum levels of IL-1, IL-6, TNF-a, amyloid-β, and S100 on postoperative day 3. POCD was assessed by the Stroop test, Trail making test-B, Porteus Maze test, Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA) on the day before surgery and the third postoperative day, along with blood samples.

resultsDemographic parameters, anaesthesia duration, exposure to anaesthetic gases, intraoperative opioid use, and blood transfusion were similar in the lidocaine ( n = 31) and dexmedetomidine ( n = 29) groups. The incidence of POCD was 29.03% in the lidocaine group and 24.1% in the dexmedetomidine group ( P = 0.77). On postoperative day 3, IL-1 levels increased by 449% with lidocaine and 202% with dexmedetomidine ( P = 0.03). TNF-a, IL-6, and S-100β levels increased similarly in both groups. There was no significant correlation between percentage changes in neuropsychological tests and biomarkers.

conclusionsThere was no significant difference in the incidence of POCD, but dexmedetomidine had a better anti-inflammatory effect in terms of lesser rise of postoperative IL-1 compared to lidocaine.

Indexed as

Anesthetics, InhalationDeliriumDexmedetomidinePostoperative Cognitive ComplicationsAgedAged, 80 and overHumansInterleukin-1Interleukin-6LidocaineMiddle AgedPostoperative ComplicationsProspective StudiesAnesthetics, InhalationDexmedetomidineInterleukin-1Interleukin-6Lidocaineabdominal surgerydexmedetomidineelderlylidocainepostoperative cognitive dysfunction

Identifiers

PMID38282502
PMCPMC10801457
OpenAlexW4391319320

What Socratic holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.