| Prophylactic lidocaine in the prehospital patient with chest pain of suspected cardiac origin. | |
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MedLine Citation:
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PMID: 2426997 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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K M Hargarten; C Aprahamian; H A Stueven; B M Thompson; J R Mateer; J Darin |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Annals of emergency medicine Volume: 15 ISSN: 0196-0644 ISO Abbreviation: Ann Emerg Med Publication Date: 1986 Aug |
Date Detail:
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Created Date: 1986-09-17 Completed Date: 1986-09-17 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8002646 Medline TA: Ann Emerg Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 881-5 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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137-58-6/Lidocaine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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