Document Detail


Effects of pericardial lidocaine on hemodynamic parameters and responses in dogs anesthetized with midazolam and fentanyl.
MedLine Citation:
PMID:  17544893     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Tachycardia during anesthesia should be avoided, especially during off-pump coronary artery bypass graft surgery. Decreasing heart rate without reducing cardiac contractility is an ideal goal. To achieve this, the authors attempted to block the cardiac nerves by pericardial administration of local anesthetic. DESIGN: A prospective study. SETTING: A laboratory. PARTICIPANTS: Anesthetized, mechanically ventilated dogs (n = 69). INTERVENTIONS: The pericardial space was infused with 2.5 or 5 mL of 1% lidocaine, 5 mL of 2% lidocaine, or normal saline solution. The hemodynamic changes and the cardiac responses to atropine or isoproterenol were measured during cardiac nerve blockade. To examine the inhibitory action of pericardial lidocaine on arrhythmias, an electrical fibrillator was installed. Furthermore, the blood level of lidocaine was measured. MEASUREMENTS AND MAIN RESULTS: Pericardial injection of lidocaine significantly decreased heart rate without a change in stroke volume. Under pericardial lidocaine, the tachycardia response to isoproterenol was similar to that observed without pericardial lidocaine, but response to atropine was significantly reduced. Pericardial lidocaine increased the voltage thresholds for inducing arrhythmias and ventricular fibrillation. Intravenous injection of lidocaine elevated the plasma concentration of lidocaine immediately, whereas the plasma concentration peaked at 10 minutes after pericardial administration. CONCLUSIONS: Pericardial lidocaine (1) decreased heart rate without affecting stroke volume, (2) preserved the tachycardiac response to isoproterenol but completely blocked the response to atropine, and (3) increased the voltage thresholds for arrhythmias and ventricular fibrillation induced by an electrical fibrillator. These results suggest that pericardial lidocaine may be useful for controlling heart rate during off-pump coronary artery bypass graft surgery.
Authors:
Motoshi Takada; Shuji Dohi; Shigeru Akamatsu; Akira Suzuki
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-05-18
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  21     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-04     Completed Date:  2007-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  393-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Pain Medicine, Gifu University Graduate School of Medicine, Gifu, Japan. mtakada_md@ybb.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Anesthesia
Animals
Coronary Artery Bypass, Off-Pump
Dogs
Fentanyl / pharmacology*
Heart Rate / drug effects*
Lidocaine / pharmacology*
Midazolam / pharmacology*
Pericardium / drug effects*
Stroke Volume / drug effects*
Ventricular Fibrillation / etiology
Chemical
Reg. No./Substance:
137-58-6/Lidocaine; 437-38-7/Fentanyl; 59467-70-8/Midazolam

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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