Evaluation of lidocaine as an adjunct to fentanyl anesthesia for coronary artery bypass graft surgery.

A double-blind, randomized, prospective trial was conducted to evaluate intravenous lidocaine, 3 mg/kg, followed by an infusion of 0.05 mg X kg-1 X min-1, as an adjunct to fentanyl in 20 patients undergoing coronary artery bypass graft surgery. Lidocaine prevented hemodynamic abnormalities during tracheal intubation and after skin incision, but was ineffective in preventing hypertension following sternotomy. Intravenous lidocaine, 3 mg/kg, produced a decrease in mean arterial pressure after fentanyl, 30 micrograms/kg, that was unacceptable in some patients. Total fentanyl requirements for the duration of surgery were similar in the control group and in patients given lidocaine. We conclude that lidocaine, when administered as an adjunct to fentanyl in the dosage used in this study, can cause cardiovascular depression, and is of minimal benefit in preventing hemodynamic abnormalities after sternotomy during coronary artery bypass graft surgery.