Document Detail


Prophylactic lidocaine in the prehospital patient with chest pain of suspected cardiac origin.
MedLine Citation:
PMID:  2426997     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prophylactic use of lidocaine in the patient with cardiac chest pain has been reported to reduce the incidence of sudden death from ventricular dysrhythmias in the hospital setting, but few studies have been done in the early prehospital phase. We conducted a randomized, prospective study comparing the effects of lidocaine versus no lidocaine in stable patients presenting with chest pain to a paramedic system. In a one-year period, 446 patients qualified for the study; 222 received lidocaine and 224 did not. The overall hospital mortality of the two groups was 8.1% and 6.7%, respectively (P = .35). Four patients in each group developed sudden death in the prehospital and emergency department settings with ventricular dysrhythmia as the precipitating rhythm. One hundred twenty-nine (29%) had an acute myocardial infarction. The lidocaine and control group contained 68 and 61 of the patients, respectively, with an overall mortality rate of 14.7% and 13.1% (P = .45). The development of significant dysrhythmias (frequent premature ventricular contractions, ventricular tachycardia, bradycardia, second- and third-degree heart blocks) after initiation into the study was similar in both groups of patients. The use of lidocaine was a factor in decreasing systolic blood pressure (P less than 0.03) but did not appear to be clinically significant. For stable patients presenting with chest pain of suspected cardiac origin, prophylactic lidocaine in the prehospital setting was not effective in preventing life-threatening dysrhythmias, but clinically significant side effects were not noted either.
Authors:
K M Hargarten; C Aprahamian; H A Stueven; B M Thompson; J R Mateer; J Darin
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  15     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  1986 Aug 
Date Detail:
Created Date:  1986-09-17     Completed Date:  1986-09-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  881-5     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Angina, Unstable / mortality
Arrhythmias, Cardiac / prevention & control*
Blood Pressure / drug effects
Cardiac Complexes, Premature / prevention & control
Clinical Trials as Topic
Death, Sudden / prevention & control*
Female
Heart Rate / drug effects
Heart Ventricles
Humans
Lidocaine / adverse effects,  pharmacology,  therapeutic use*
Male
Myocardial Infarction / complications,  mortality
Pain* / etiology
Prospective Studies
Random Allocation
Sex Factors
Tachycardia / prevention & control
Thorax*
Ventricular Fibrillation / prevention & control
Chemical
Reg. No./Substance:
137-58-6/Lidocaine

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


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