Lidocaine for prevention of reperfusion ventricular fibrillation after release of aortic cross-clamping

Objective: To determine the efficacy of a bolus of lidocaine administered b y way of the pump before releasing the aortic cross-clamp (ACC) in preventi ng the occurrence of reperfusion ventricular fibrillation. Design: Prospective, randomized study. Setting: University hospital. Participants:Patients undergoing coronary artery bypass graft surgery (n = 34). Interventions:Seventeen patients received 100 mg of lidocaine by way of the pump 2 minutes before releasing the ACC, and a control group of 17 patient s received 5 mt of normal saline. Measurements and Main Results: In the control group, the incidence of reper fusion ventricular fibrillation was 70%, which was significantly decreased to 11% in the lidocaine group. A higher cardiac output after weaning from c ardiopulmonary bypass was observed in the lidocaine group; this may be attr ibuted to the lower incidence of reperfusion ventricular fibrillation and c onsequently the lower need for defibrillation by electric countershocks. Conclusions: The results suggest that a bolus of 100 mg of lidocaine admini stered 2 minutes before release of the ACC can safely decrease the incidenc e of reperfusion ventricular fibrillation and is associated with better hem odynamics after weaning from cardiopulmonary bypass. Copyright (C) 2000 by W.B. Saunders Company.