Trial Probes: Can Lidocaine Make Heart Bypass Surgery Less Risky by Reducing Inflammation?
Fighting Inflammation in the Operating Room
Heart surgery with cardiopulmonary bypass (CPB), though life-saving, sparks a powerful inflammatory response in the body. This “fire within” can lead to complications—ranging from kidney injury and lung issues to delirium—by flooding the bloodstream with proinflammatory molecules like interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α). Despite medical advances, doctors still lack a reliable way to tame this response and protect organs during and after surgery.
A Fresh Look at an Old Drug: Lidocaine
Researchers in Spain are testing whether intravenous lidocaine, a medication best known for numbing pain and calming abnormal heart rhythms, can also reduce inflammation during heart surgery. This double-blind, randomized clinical trial involves 90 adults scheduled for elective valve or coronary surgery using CPB at San Pedro University Hospital.
Half the patients will receive lidocaine (a calculated bolus and infusion) during surgery, while the other half receives a saline placebo. The primary focus: IL-6 levels 6 hours after surgery—a key measure of how “inflamed” the body gets.
What Else Will the Study Measure?
Beyond IL-6, the team will track:
Other inflammation markers (CRP, TNF-α)
Heart muscle injury (troponin T)
Common complications tied to inflammation (kidney injury, infection, delirium, vasoplegia, and multiorgan failure)
ICU stays and 30-day survival
Pain and opioid use after surgery
Blood samples and clinical data will be collected at multiple points before, during, and after the operation to create a detailed map of the body’s response.
Why Lidocaine?
Lidocaine’s anti-inflammatory powers have been seen in non-cardiac surgeries, but evidence in heart surgery is scarce. It’s believed to help by stabilizing cell membranes and suppressing the immune response, possibly protecting delicate blood vessel linings and reducing damage from the surgical “storm.”
What’s the Potential Impact?
If lidocaine proves effective, it could become a simple, cost-effective way to make heart surgeries safer—cooling the body’s inflammatory fire and improving recovery. This trial sets the stage for larger studies and, perhaps, a new standard of care.
Key Takeaways:
Cardiopulmonary bypass in heart surgery triggers a major inflammatory response.
This trial tests if intravenous lidocaine can reduce systemic inflammation and complications.
Primary outcome: IL-6 levels at 6 hours post-surgery.
Other measures: Organ injury, ICU stay, pain, and survival.
Results could point to an easy, affordable way to improve heart surgery outcomes.
Citation:
Fernández-Martínez, A., López Picado, A., González-García, J., et al. (2026). Evaluation of the Effect of Intravenous Lidocaine on the Systemic Inflammatory Response Associated With Cardiopulmonary Bypass in Valvular and/or Coronary Cardiac Surgery: Protocol for a Double-Blind Randomized Clinical Trial. Journal of Cardiothoracic and Vascular Anesthesia, 40, 1668–1677. https://doi.org/10.1053/j.jvca.2026.01.008
