Document Detail


Lidocaine prophylaxis in coronary revascularization patients: a randomized, prospective trial.
MedLine Citation:
PMID:  8494429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Life-threatening ventricular ectopy can occur after cardiac operations. The actual incidence of ventricular ectopy and the ability to prevent it by the routine prophylactic use of lidocaine hydrochloride have not been established. We performed a double-blind, randomized, prospective trial involving 109 patients undergoing elective coronary artery revascularization. Patients received either lidocaine (n = 54) or a placebo (n = 55) after separation from bypass. A Holter monitor was affixed to each patient for subsequent review, and bedside intensive-care monitors with alarms were used for "real-time" surveillance. The code was broken when potentially malignant ventricular ectopy or side effects attributable to the study drug were noted. Three lidocaine patients and 2 placebo patients were dropped from the study because of hemodynamic instability or bleeding. Of the remaining 104 patients, the code was broken in 12 (24%) of the 51 in the lidocaine group (9 for ectopy and 3 for mental status changes) and 10 (19%) of the 53 in the placebo group (all for ectopy) (p = not significant). Twenty-four-hour Holter monitor evaluation demonstrated occasional ventricular ectopy in all patients and nonsustained ventricular tachycardia in 28% in the lidocaine group and 48% in the placebo group (p = not significant). The mean number of runs of ventricular tachycardia per patient was 0.53 in the lidocaine group and 1.6 in the placebo group (p = 0.035). There were no significant differences in terms of other ventricular ectopy, morbidity, or mortality. No ventricular fibrillation occurred in either group.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R G Johnson; A L Goldberger; R L Thurer; M Schwartz; C Sirois; R M Weintraub
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  55     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-06-17     Completed Date:  1993-06-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1180-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Beth Israel Hospital, Harvard Medical School, Boston, MA 02115.
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MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac / prevention & control*
Atrial Fibrillation / etiology
Atrial Flutter / etiology
Cardiac Output, Low / etiology
Coronary Artery Bypass* / adverse effects
Double-Blind Method
Electrocardiography, Ambulatory
Female
Follow-Up Studies
Humans
Lidocaine / therapeutic use*
Male
Middle Aged
Placebos
Prospective Studies
Respiratory Insufficiency / etiology
Tachycardia, Ventricular / etiology
Ventricular Function / drug effects
Chemical
Reg. No./Substance:
0/Placebos; 137-58-6/Lidocaine

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


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