Rihn T L, DeBalko J N, Keys P W
Am J Hosp Pharm. 1981 Jul;38(7):1017-21.
An audit of lidocaine use in critical-care areas of a hospital is reported. Fifty adult patients for whom lidocaine was prescribed were admitted to the study; 31 were men. Using process, outcome, and complication criteria, the investigators reviewed the patients' medical records. If a deviation from accepted criteria was found, a medical audit committee (composed of physicians) reviewed the records and decided if the deviation was warranted. The audit results showed good compliance with the established criteria. Some minimal deficiencies were found in how lidocaine administration was initiated (6%), when a constant infusion was begun (12%), the rate of constant infusion (2%), and converting to oral therapy (2%). There was substantial deviation from criteria when ventricular arrhythmias recurred during lidocaine therapy. No major deficiencies in management of lidocaine toxicity were found. Recommendations that resulted from the audit are discussed.
本文报告了一家医院重症监护区利多卡因使用情况的审计结果。五十名被开具了利多卡因的成年患者纳入了本研究，其中31名为男性。研究者依据流程、结果及并发症标准，查阅了患者的病历记录。若发现有不符合既定标准的情况，由医生组成的医疗审计委员会会对记录进行审查，并判定该偏差是否合理。审计结果显示，对既定标准的依从性良好。在利多卡因给药起始方式（6%）、开始持续输注的时间（12%）、持续输注速率（2%）以及转为口服治疗（2%）方面发现了一些轻微不足。在利多卡因治疗期间室性心律失常复发时，与标准存在显著偏差。未发现利多卡因毒性管理方面的重大不足。文中讨论了此次审计得出的建议。
