Effect of Single Dose of Lidocaine before Removal of Cross-Clamp on Prevention of Ventricular Fibrillation in On-Pump CABG Surgery

Abstract

Objective: To determine the efficacy of Lidocaine administration before removal of cross-clamp on prevention of Ventricular Fibrillation (VF) in patients who underwent Coronary Artery Bypass Graft (CABG). Study Design: Quasi-experimental study. Place and Duration of Study: Department of Cardiothoracic Anesthesia, Army Cardiac Center, Lahore Pakistan, from Sep 2021 to Mar 2022. Methodology: One hundred and sixty-two patients were selected non-randomly via consecutive sampling. Patients were divided into two groups i.e., Control and Lidocaine group. Patients of control group were given intravenous Normal Saline while patients in Lidocaine group were given intravenous 2% Lidocaine in dose of 1mg/kg just before release of aortic cross clamp. Main outcome variable was frequency of Ventricular Fibrillation after removal of cross-clamp whereas bypass time, cross-clamp time, Mean Arterial Pressure (MAP) after cardiopulmonary bypass were noted for comparison purpose. Chisquare and t-test were used to compare frequency and mean differences of study variables among study groups. p-value<0.05 was considered statistically significant. Results: One hundred and sixty-two patients with mean age 55.92±6.81 years were recruited. Ventricular Fibrillation (VF) was noted in 43(53.1%) in control group and 11(13.5%) in Lidocaine group (p<0.001). The use of intravenous Lidocaine caused reperfusion VF to occur less frequently which in turn reduced the requirement for electric counter-shock defibrillation. Conclusion: The use of intravenous Lidocaine (1 mg/kg) 2 minutes prior to release of the aortic cross-clamp decreased the frequency of reperfusion Ventricular Fibrillation among subjects who underwent CABG.

Keywords

• Coronary Artery Bypass Graft
• Cross Clamp
• Lidocaine
• Reperfusion Ventricular Fibrillation