Abstract
This double-blind controlled study examined the frequency of ventricular arrhythmias (premature ventricular contractions (PVCs) > 5 · min− 1, bigeminy, couplets, ventricular tachycardia, and ventricular fibrillation) in coronary artery bypass graft (CABG) patients during the first 24 hr postoperatively to determine the effect of prophylactic lidocaine on reducing the frequency of ventricular arrhythmias. Patients were included in the study if they had undergone CABG only, and had not received treatment for ventricular arrhythmias before coming off cardiopulmonary bypass. A total of 83 patients were studied and were randomly allocated to 43 in the placebo control group and 40 in the lidocaine-treated group. The results showed that 67 per cent of patients in the placebo group and 33 per cent of patients in the lidocaine treated group had ventricular arrhythmias (P < 0.005). There was also a significant reduction in ventricular fibrillation and ventricular tachycardia in the lidocaine treated group (P < 0.01). It is recommended that a routine infusion of lidocaine, 100 mg bolus followed by 2 mg · kg− 1, be given to every postoperative coronary artery bypass patient for at least the first 24 hours.
Résumé
Pendant les 24 premières heures suivant une revascularisation coronarienne, nous avons mesuré dans une étude randomisée à double insu, l’effet d’une infusion prophylactique de lidocaïne sur la fréquence des arythmies ventriculaires (extrasystoles ventriculaires > 5 min−1, bigéminisme, doublets, tachycardie et fibrillation ventriculaires). N’étaient inclus dans l’étude que les patients ayant subi une revascularisation seule et n’ayant eu aucune arythmie ventriculaire nécessitant une traitement avant le sevrage de la circulation extra-corporelle. Il appert que 67 pour cent des 43 patients du groupe placébo et 33 pour cent des 40 patients du groupe lidocaïne eurent des arythmies ventriculaires (P < 0,005). La tachycardie et la fibrillation ventriculaires étaient aussi moins fréquentes dans le groupe lidocaïne (P < 0,01). Nous recommandons, dans tous les cas de revascularisation coronarienne, l’utilisation prophylactique de lidocaïne à raison d’un bolus de 100 mg suivi d’une perfusion à 2 mg min−1 pendant au moins 24 heures.
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King, F.G., Addetia, A.M., Peters, S.D. et al. Prophylactic lidocaine for postoperative coronary artery bypass patients, a double-blind, randomized trial. Can J Anaesth 37, 363–368 (1990). https://doi.org/10.1007/BF03005592
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DOI: https://doi.org/10.1007/BF03005592