77167
document
Prophylactic lidocaine in the early phase of suspected myocardial infarction . Four hundred two patients with suspected myocardial infarction seen within 6 hours of the onset of symptoms entered a double-blind randomized trial of lidocaine vs placebo . During the 1 hour after administration of the drug the incidence of ventricular fibrillation or sustained ventricular tachycardia among the 204 patients with acute myocardial infarction was low , 1.5 % . Lidocaine , given in a 300 mg dose intramuscularly followed by 100 mg intravenously , did not prevent sustained ventricular tachycardia , although there was a significant reduction in the number of patients with warning arrhythmias between 15 and 45 minutes after the administration of lidocaine ( p less than 0.05 ) . The average plasma lidocaine level 10 minutes after administration for patients without a myocardial infarction was significantly higher than that for patients with an acute infarction . The mean plasma lidocaine level of patients on beta-blocking agents was no different from that in patients not on beta blocking agents . During the 1-hour study period , the incidence of central nervous system side effects was significantly greater in the lidocaine group , hypotension occurred in 11 patients , nine of whom had received lidocaine , and four patients died from asystole , three of whom had had lidocaine . We can not advocate the administration of lidocaine prophylactically in the early hours of suspected myocardial infarction .
77168
Intervention_Pharmacological
Prophylactic lidocaine
77169
Intervention_Pharmacological
lidocaine
77170
Intervention_Control
placebo
77171
Intervention_Pharmacological
Lidocaine
77172
Intervention_Pharmacological
lidocaine
77173
Intervention_Pharmacological
lidocaine
77174
Intervention_Pharmacological
lidocaine
77175
Intervention_Pharmacological
lidocaine
77176
Intervention_Pharmacological
lidocaine
77177
Outcome_Physical
incidence of ventricular fibrillation
77178
Outcome_Physical
sustained ventricular tachycardia
77179
Outcome_Physical
sustained ventricular tachycardia
77180
Outcome_Physical
number of patients with warning arrhythmias
77181
Outcome_Physical
average plasma lidocaine level
77182
Outcome_Other
minutes after
77183
Outcome_Physical
mean plasma lidocaine level
77184
Outcome_Adverse-effects
incidence of central nervous system side effects
77185
Outcome_Physical
hypotension
77186
Outcome_Mortality
died
77187
Participant_Sample-size
Four hundred two
77188
Participant_Condition
myocardial infarction
77189
Participant_Sample-size
204