Rademaker A W, Kellen J, Tam Y K, Wyse D G
Clin Pharmacol Ther. 1986 Jul;40(1):71-80. doi: 10.1038/clpt.1986.141.
Adverse effects of lidocaine therapy for proved or suspected myocardial infarction were evaluated for 48 hours in 285 patients arriving at the hospital within 6 hours of the onset of chest pain. More adverse effects occurred in patients receiving lidocaine (51%) than in those receiving placebo (16%; P less than 0.0001). Patients receiving lidocaine had more adverse effects in the first 12 hours as compared with the second 12 hours (50% vs. 19%; P less than 0.001). Patients without infarction who received lidocaine had more adverse effects than similarly dosed patients with infarction (64% vs. 39%; P = 0.002). The proportion of major adverse effects in those patients having any adverse effect was much greater in the last 24 hours as compared with the first 24 hours (86% vs. 32%; P = 0.006). All life-threatening problems (n = 5) occurred in the first 24 hours, most frequently in the first hour. Lidocaine levels were only weakly related to adverse effects potentially caused by lidocaine toxicity. We conclude that the adverse effects of prophylactic lidocaine have been understated in the past and may negate its antiarrhythmic efficacy.
对285名在胸痛发作6小时内入院的患者进行了48小时的评估，以观察利多卡因治疗已证实或疑似心肌梗死的不良反应。接受利多卡因治疗的患者（51%）比接受安慰剂的患者（16%；P<0.0001）出现更多不良反应。与后12小时相比，接受利多卡因治疗的患者在前12小时出现更多不良反应（50%对19%；P<0.001）。未发生梗死但接受利多卡因治疗的患者比同样剂量的梗死患者出现更多不良反应（64%对39%；P=0.002）。与前24小时相比，在出现任何不良反应的患者中，严重不良反应的比例在最后24小时要高得多（86%对32%；P=0.006）。所有危及生命的问题（n=5）均发生在前24小时，最常见于第1小时。利多卡因水平与利多卡因毒性可能引起的不良反应仅存在微弱关联。我们得出结论，预防性使用利多卡因的不良反应在过去被低估了，可能会抵消其抗心律失常的疗效。
