The Annals of Thoracic Surgery, Vol 55, 1529-1533, Copyright © 1993 by The Society of Thoracic Surgeons
Lidocaine cardioplegia for prevention of reperfusion ventricular fibrillation
A Baraka, N Hirt, A Dabbous, S Taha, C Rouhana, N el-Khoury, M Ghabash, M Jamhoury and A Sibaii
Department of Anesthesiology, American University of Beirut, Lebanon.
Lidocaine addition to crystalloid cardioplegic solution for prevention of
reperfusion ventricular fibrillation after the release of the aortic
cross-clamp was studied in 50 patients undergoing coronary artery bypass
grafting and in 30 patients undergoing mitral or aortic valve replacement.
Twenty-six of the patients undergoing coronary artery bypass grafting
received lidocaine, 100 mg/L of cardioplegia, whereas a control group of 24
patients received cardioplegia without lidocaine. In the group undergoing
valve replacement, 14 patients received lidocaine cardioplegia and 16
patients served as control. In the coronary artery bypass grafting group,
lidocaine cardioplegia reduced significantly the incidence of reperfusion
ventricular fibrillation from 100% to 42%. In the valve group, lidocaine
cardioplegia also reduced significantly the incidence of reperfusion
ventricular fibrillation from 93% to 42%. In both groups, lidocaine
cardioplegia decreased the number of direct-current countershocks required
to defibrillate the heart, with no significant increase in the incidence of
high-grade atrioventricular block.