title: Impact of intravenous lidocaine on myocardial injury after off-pump coronary artery surgery.
abstract: BACKGROUND
  Lidocaine has been demonstrated to exert cardioprotective effects against myocardial ischaemia and reperfusion injury. We evaluated whether a continuous i.v. infusion of lidocaine reduced myocardial injury in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB).
  
  
  METHODS
  In this randomized, double-blinded trial, 99 patients received i.v. lidocaine 2% (i.e. a 1.5 mg kg(-1) bolus at induction of anaesthesia followed by a 2.0 mg kg(-1) h(-1) infusion intraoperatively) or an equal volume of saline. Serum creatine kinase-myocardial band (CK-MB) and troponin I (TnI) concentrations were measured before surgery, upon arrival in the intensive care unit, and at 6, 24, 48, and 72 h after surgery. Cardiac enzymes, other biological markers, and rate of postoperative adverse events were compared between the groups.
  
  
  RESULTS
  The median (25-75% inter-quartile range) TnI [0.90 (0.43-1.81) vs 1.71 (0.88-3.02) ng ml(-1), P=0.027] and CK-MB [6.5 (3.9-12.3) vs 9.8 (6.0-18.6) ng ml(-1), P=0.005] concentrations 24 h after surgery were significantly lower in the lidocaine group than in the control group. Moreover, lidocaine infusion reduced the total area under the curve of TnI and CK-MB release after surgery by 42% and 27%, respectively, compared with control.
  
  
  CONCLUSIONS
  Continuous i.v. infusion of lidocaine during surgery reduces myocardial injury in patients undergoing OPCAB.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap 2-dong, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: E-H
authors.initials: EH
authors.lastname: Lee
authors.forename: H-M
authors.initials: HM
authors.lastname: Lee
authors.forename: C-H
authors.initials: CH
authors.lastname: Chung
authors.forename: J-H
authors.initials: JH
authors.lastname: Chin
authors.forename: D-K
authors.initials: DK
authors.lastname: Choi
authors.forename: H-J
authors.initials: HJ
authors.lastname: Chung
authors.forename: J-Y
authors.initials: JY
authors.lastname: Sim
authors.forename: I-C
authors.initials: IC
authors.lastname: Choi
mesh_terms: D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D052279:Creatine Kinase, MB Form / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000201:enzymology / Q000209:etiology / Q000517:prevention & control*; D019210:Troponin I / Q000097:blood
chemical_list: D000779:Anesthetics, Local; D015415:Biomarkers; D002316:Cardiotonic Agents; D019210:Troponin I; D008012:Lidocaine; D052279:Creatine Kinase, MB Form