Inclusion Criteria:  Elective spinal fusion surgery Estimated length of stay ≥3 days Fluent in English  Exclusion Criteria:  Surgical:  2-stage spine surgery i.e. anterior-posterior on separate days* Cervical spine surgery Non-spine surgeries  Other:  Allergy or intolerance of lidocaine Significant heart disease (2nd or 3rd heart block without a pacemaker, Left ventricular ejection fraction (LVEF) <30%, significant arrhythmia [Adams-strokes, Wolff-Parkinson-white syndrome], concurrent treatment with a class 1 antiarrhythmic or amiodarone) Significant hepatic or renal dysfunction History of uncontrolled seizures Acute porphyria Preoperative usage of long-acting opioids (methadone, buprenorphine, fentanyl patch, ms-contin, oxycontin) or preoperative opioid usage greater than or equal to the equivalent of 60 mg of oral morphine equivalents. Severe cognitive impairment (reported by proxy or a score of >5 on the Short Portable Mental Status Questionnaire (SPMSQ)) Self-, or proxy-reported physical impairment preventing the subject from consenting or answering questions Evidence of preoperative delirium Participated in Clinical Trial of Gabapentin to Decrease Postoperative Delirium and Pain (GIPP) or Postoperative Cognition in Older Adult Surgical Patients (PCD) study previously Participating in any other clinical trial