Baraka A, Hirt N, Dabbous A, Taha S, Rouhana C, el-Khoury N, Ghabash M, Jamhoury M, Sibaii A
Department of Anesthesiology, American University of Beirut, Lebanon.
Ann Thorac Surg. 1993 Jun;55(6):1529-33. doi: 10.1016/0003-4975(93)91104-u.
Lidocaine addition to crystalloid cardioplegic solution for prevention of reperfusion ventricular fibrillation after the release of the aortic cross-clamp was studied in 50 patients undergoing coronary artery bypass grafting and in 30 patients undergoing mitral or aortic valve replacement. Twenty-six of the patients undergoing coronary artery bypass grafting received lidocaine, 100 mg/L of cardioplegia, whereas a control group of 24 patients received cardioplegia without lidocaine. In the group undergoing valve replacement, 14 patients received lidocaine cardioplegia and 16 patients served as control. In the coronary artery bypass grafting group, lidocaine cardioplegia reduced significantly the incidence of reperfusion ventricular fibrillation from 100% to 42%. In the valve group, lidocaine cardioplegia also reduced significantly the incidence of reperfusion ventricular fibrillation from 93% to 42%. In both groups, lidocaine cardioplegia decreased the number of direct-current countershocks required to defibrillate the heart, with no significant increase in the incidence of high-grade atrioventricular block.
在50例行冠状动脉搭桥术的患者和30例行二尖瓣或主动脉瓣置换术的患者中，研究了在晶体心脏停搏液中添加利多卡因以预防主动脉阻断钳松开后再灌注性室颤的效果。26例行冠状动脉搭桥术的患者接受了含100mg/L利多卡因的心脏停搏液，而24例患者组成的对照组接受不含利多卡因的心脏停搏液。在瓣膜置换术组中，14例患者接受利多卡因心脏停搏液，16例患者作为对照。在冠状动脉搭桥术组中，利多卡因心脏停搏液使再灌注性室颤的发生率从100%显著降低至42%。在瓣膜组中，利多卡因心脏停搏液也使再灌注性室颤的发生率从93%显著降低至42%。在两组中，利多卡因心脏停搏液均减少了心脏除颤所需的直流电复律次数，且高度房室传导阻滞的发生率无显著增加。
