***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background and Purpose — Cognitive decline after cardiac surgery remains common and diminishes patients ' quality of life . Based on experimental and clinical evidence , this study assessed the potential of intravenously administered lidocaine to reduce postoperative cognitive dysfunction after cardiac surgery using cardiopulmonary bypass . Methods — After IRB approval , 277 patients undergoing cardiac surgery were enrolled into this prospect i ve , r and omized , double-blinded placebo controlled clinical trial . Subjects were r and omized to receive : ( 1 ) Lidocaine as a 1 mg/kg bolus followed by a continuous infusion through 48 hours postoperatively , or ( 2 ) Placebo bolus and infusion .  Cognitive function was assessed preoperatively and again at 6 weeks and 1 year postoperatively . The effect of lidocaine on postoperative cognition was tested using multivariable regression modeling ; P<0.05 was considered significant . Results — Among the 241 allocated subjects  ( Lidocaine : n=114 ; Placebo : n=127 ) , the incidence of cognitive deficit in the lidocaine group was 45.5 % versus 45.7 % in the placebo group ( P=0.97 ) . Multivariable analysis revealed a significant interaction between treatment group and diabetes , such that diabetic subjects receiving lidocaine were more likely to suffer cognitive decline ( P=0.004 ) . Secondary analysis identified total lidocaine dose ( mg/kg ) as a significant predictor of cognitive decline and also revealed a protective effect of lower dose lidocaine in nondiabetic subjects . Conclusions — Lidocaine administered during and after cardiac surgery does not reduce the high rate of postoperative cognitive dysfunction . Higher doses of lidocaine and diabetic status were independent predictors of cognitive decline . Protective effects of lower dose lidocaine in nondiabetic subjects need to be further evaluated We investigated the effect of lidocaine on the incidence of cognitive dysfunction in the early postoperative period after cardiac surgery . One-hundred-eighteen patients undergoing elective coronary artery bypass surgery with cardiopulmonary bypass ( CPB ) were r and omized to receive either lidocaine ( 1.5 mg/kg bolus followed by a 4 mg/min infusion during operation and 4 mg/kg in the priming solution of CPB ) or placebo . A battery of nine neuropsychological tests was administered before and 9 days after surgery . A postoperative deficit in any test was defined as a decline by more than or equal to the preoperative sd of that test in all patients . Any patient showing a deficit in two or more tests was defined as having postoperative cognitive dysfunction .  Eighty-eight patients completed pre- and postoperative neuropsychological tests . Plasma lidocaine concentrations ( & mgr;g/mL ) were 4.78 ± 0.52 ( mean ± sd ) , 5.38 ± 0.95 , 4.52 ± 0.39 , 5.82 ± 0.76 , and 7.10 ± 1.09 at 10 min before CPB ; 10 , 30 , and 60 min of CPB ; and at the end of operation , respectively . The proportion of patients showing postoperative cognitive dysfunction was significantly reduced in the lidocaine group compared with that in the placebo group ( 18.6 % versus 40.0%;P = 0.028 ) . We conclude that intraoperative administration of lidocaine decreased the occurrence of cognitive dysfunction in the early postoperative period BACKGROUND : Surgery-associated tissue injury leads to nociception and inflammatory reaction , accompanied by increased production of proinflammatory cytokines . These cytokines can induce peripheral and central sensitization , leading to pain augmentation . Recently , a frequently used local anesthetic , lidocaine , was introduced as a part of a perioperative pain management technique . In addition to its analgesic effects , lidocaine has an antiinflammatory property , decreasing the upregulation of proinflammatory cytokines . We focused on the effects of preincisional and intraoperative IV lidocaine on pain intensity and immune reactivity in the postoperative period . METHODS : Sixty-five female patients ( ASA physical status I – II ) scheduled for transabdominal hysterectomy were recruited to this r and omized , placebo-controlled study . Thirty-two patients in the treatment group received IV lidocaine starting 20 min before surgery , whereas the control group ( 33 patients ) received a matched saline infusion . Both groups received patient-controlled epidural analgesia during the postoperative period . Blood sample s were collected before , 24 , 48 , and 72 h after surgery to measure ex vivo cytokine production of interleukin (IL)-1 receptor antagonist ( IL-1ra ) and IL-6 , as well lymphocyte mitogenic response to phytohemagglutinin-M. A 10-cm visual analog scale was used to assess pain intensity at rest and after coughing . RESULTS : Patients in the lidocaine + patient-controlled epidural analgesia group experienced less severe postoperative pain in the first 4 and 8 h after surgery ( visual analog scale 4/3.7 at rest and 5.3/5 during coughing versus 4.5/4.2 and 6.1/5.3 , respectively , in the placebo group ) . There was significantly less ex vivo production of IL-1ra and IL-6 , whereas the lymphocyte proliferation response to phytohemagglutinin-M was better maintained than in the control group . CONCLUSION : The present findings indicate that preoperative and intraoperative IV lidocaine improves immediate postoperative pain management and reduces surgery-induced immune alterations Background : Both postoperative epidural analgesia and intravenous ( IV ) infusion of local anesthetic have been shown to shorten ileus duration and hospital stay after colon surgery when compared with the use of systemic narcotics alone . However , they have not been compared directly with each other . Methods : Prospect i ve , r and omized clinical trial was conducted comparing the 2 treatments in open colon surgery patients . Before induction of general anesthesia , patients were r and omized either to epidural analgesia ( bupivacaine 0.125 % and hydromorphone 6 & mgr;g/mL were started at 10 mL/hr within 1 hr of the end of surgery ) or IV lidocaine ( 1 mg/min in patients < 70 kg , 2 mg/min in patients ≥70 kg ) . Markers of return of bowel function , length of stay , postoperative pain scores , systemic analgesic requirements , and adverse events were recorded and compared between the 2 groups in an intent-to-treat analysis . Results : Study enrollment took place from April 2005 to July 2006 . Twenty-two patients were r and omized to IV lidocaine therapy and 20 patients to epidural therapy . No statistically significant differences were found between groups in time to return of bowel function or hospital length of stay . The median pain score difference was not statistically significant . No statistically significant differences were found in pain scores for any specific postoperative day or in analgesic consumption . Conclusions : No differences were observed between groups in terms of return of bowel function , duration of hospital stay , and postoperative pain control , suggesting that IV infusion of local anesthetic may be an effective alternative to epidural therapy in patients in whom epidural anesthesia is contraindicated or not desired OBJECTIVE This study was design ed to evaluate whether a continuous low-dose lidocaine infusion reduces postoperative pain and anxiety in patients undergoing coronary artery bypass grafting ( CABG ) and to retrospectively examine time to extubation , intensive care unit stay ( ICU ) , and hospital length of stay . DESIGN A double-blinded , r and omized , and prospect i ve approach . SETTING Hospital patients undergoing first-time CABG . PARTICIPANTS After informed consent , 100 patients were enrolled in this study . INTERVENTIONS Lidocaine infusion or placebo substitute was begun after induction of anesthesia . The fentanyl/midazolam infusion was discontinued on ICU admission ; lidocaine or placebo continued until ICU discharge . Supplemental fentanyl , midazolam , or propranolol was administered for pain , anxiety , or hemodynamic stress . MEASUREMENTS AND MAIN RESULTS Drug dosages were compared between groups . Postoperative assessment included visual analog pain score , hemodynamics , sedation score , and nursing assessment . Mean total dosages of fentanyl , midazolam , and propranolol between the lidocaine and placebo groups were 620.40 + /- 815.74 microgram versus 689.16 + /- 692.99 microgram , p = 0.244 ; 0.54 + /- 1.13 mg versus 1.20 + /- 2.44 mg p = 0.465 ; 0.11 + /- 0.75 mg versus 3.56 + /- 17.2 mg , p = 0.564 , respectively . Times to extubation , ICU length of stay , and hospital stay did not achieve statistical significance . CONCLUSIONS Continuous infusion of low-dose lidocaine did not significantly decrease supplemental fentanyl , midazolam , or propranolol requirement postoperatively . Similarly , a lidocaine infusion does not result in reduced time to extubation . ICU stay , or hospital length of stay Background : The analgesic effect of perioperative low doses of intravenous lidocaine has been demonstrated after abdominal surgery . This study aim ed to evaluate whether a continuous intravenous low-dose lidocaine infusion reduced  postoperative pain and modified nociceptive pain threshold after total hip arthroplasty . Methods : Sixty patients participated in this r and omized double-blinded study . Patients received lidocaine 1 % ( lidocaine group ) with a 1.5 mg/kg−1 intravenous bolus in 10 min followed by a 1.5 mg · kg−1 · h−1 intravenous infusion or saline ( control group ) . These regimens were started 30 min before surgical incision and stopped 1h after skin closure .  Lidocaine blood concentrations were measured at the end of administration . In both groups , postoperative analgesia was provided exclusively by patient-controlled intravenous morphine . Pain scores , morphine consumption , and operative hip flexion were recorded over 48 h. In addition , pressure pain thresholds and the extent of hyperalgesia around surgical incision were systematic ally measured at 24 and 48 h. Results : In comparison with the placebo , lidocaine did not induce any opioid-sparing effect during the first 24 h ( median [ 25–75 % interquartile range ] ; 17 mg [ 9–28 ] vs. 15 mg [ 8–23 ] ; P = 0.54 ) . There was no significant difference regarding the effects of lidocaine and placebo  on pain score , pressure pain thresholds , extent in the area of hyperalgesia , and maximal degree of active hip flexion tolerated . Mean plasma lidocaine concentration was 2.1 ± 0.4 & mgr;g/ml . Conclusion : Low dose perioperative intravenous lidocaine  after total hip arthroplasty offers no beneficial effect on postoperative analgesia and does not modify pressure and tactile pain thresholds Purpose Intravenous lidocaine given both intraoperatively and postoperatively decreases pain scores , reduces opioid consumption , and promotes faster return of bowel function following abdominal surgery . The purpose of this trial was to determine if intravenous lidocaine limited to the intraoperative period reduces length of hospital stay and improves functional recovery following abdominal hysterectomy . Methods Following Research Ethics Board approval and informed consent , women of American Society of Anesthesiologists ’ class I and II undergoing abdominal hysterectomy were assigned r and omly to lidocaine and control groups . Lidocaine subjects received an intravenous bolus of 1.5 mg·kg−1 followed by an infusion of 3 mg·kg−1·hr−1 , while control subjects received matching placebo . Patients , anesthesiologists , and study personnel were blinded , and anesthesia and multimodal perioperative analgesia were st and ardized . The primary outcome of this trial was discharge from hospital on or before the second postoperative day ( POD2 ) . Additional criteria were assessed for secondary outcomes , i.e. , discharge fitness on POD2 , length of hospital stay , opioid use , numeric rating scores for pain , quality of recovery , and recovery of bowel function . Results Ninety of the 93 women who were recruited completed the study protocol . The characteristics of the patients in both groups were similar — lidocaine group ( n = 44 ) and control group ( n = 46)— and no difference was noted between groups in the numbers of women discharged from hospital on POD2 ( 10 lidocaine , 15 control ; P = 0.295 ) . Days to discharge fitness ( P = 0.666 ) and length of hospital stay ( P = 0.456 ) were also similar . Differences in opioid consumption , pain scores , and recovery were neither clinical ly nor statistically significant . Conclusion Intraoperative administration of intravenous lidocaine did not reduce hospital stay or improve objective measures of analgesia and recovery following abdominal hysterectomy . This trial was registered at Clinical Trials.gov (NCT00382499).RésuméObjectifLa lidocaïne int 
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METHODS CENTRAL , MEDLINE , EMBASE , and CINAHL data bases and Clinical Trials.gov , and congress proceedings were search ed for r and omized controlled trials until May 2014 , that compared patients who did or did not receive continuous perioperative i.v .
There was limited evidence of positive effects of lidocaine on postoperative gastrointestinal recovery , opioid requirements , postoperative nausea and vomiting , and length of hospital stay .
There is limited evidence suggesting that i.v .
lidocaine may be a useful adjuvant during general anaesthesia because of its beneficial impact on several outcomes after surgery