title: The effect of lidocaine and amiodarone on prevention of ventricular fibrillation in patients undergoing coronary artery bypass grafting.
abstract: OBJECTIVE
  Ventricular fibrillation is common after aortic declamping in patients undergoing open heart surgery. This situation has a negative impact on morbidity and mortality. The aim of this prospective study was to compare the effect of administering lidocaine versus amiodarone before aortic declamping during elective coronary bypass grafting, paying close attention to when the initial effect of amiodarone sets in.
  
  
  METHODS
  In this double blind, prospective, randomized, controlled study, 86 patients who were candidates for elective coronary artery bypass grafting were recruited into three groups: group lidocaine (group L, n=29); group amiodarone (group A, n=27); and group placebo (group P, n=30). Group L patients received 1.5 mg/kg of lidocaine 2 minutes before aortic declamping and group A patients received 300 mg of amiodarone intravenously 15 minutes before release of the aortic cross clamp. The primary endpoints were the incidence of ventricular fibrillation and the number of shocks required to terminate ventricular fibrillation.
  
  
  RESULTS
  The frequency of ventricular fibrillation occurrence was significantly higher in group P (70%) when compared with group A (37%) and group L (38%) (P=.017). There was no statistically significant difference between the amiodarone and the lidocaine groups regarding ventricular fibrillation. However, when ventricular fibrillation occurred, the percentage of patients requiring electrical defibrillation was significantly higher in both group L and group P when compared with group A (P=.023).
  
  
  CONCLUSIONS
  We suggest that during coronary arterial bypass surgery, administration of an amiodarone regime before release of the aortic cross clamp, paying particular attention to the start of the initial effect of amiodarone, is no more effective than lidocaine for prevention from arrhythmia; however, amiodarone reduces the need for electrical defibrillation.
authors.affiliation: Department of Anesthesiology, Kocaeli Derince Education and Research Hospital, Kocaeli.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yilmaz
authors.affiliation: Department of Cardiovascular Surgery, Kocaeli Derince Education and Research Hospital, Kocaeli.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Aydin
authors.affiliation: Department of Anesthesiology, Kocaeli Derince Education and Research Hospital, Kocaeli.
authors.forename: Zehra Ipek
authors.initials: ZI
authors.lastname: Arslan
authors.affiliation: Department of Anesthesiology, Kocaeli Derince Education and Research Hospital, Kocaeli.
authors.forename: Canan
authors.initials: C
authors.lastname: Balcı
authors.affiliation: Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey.
authors.forename: Cevdet Ugur
authors.initials: CU
authors.lastname: Kocogullari
authors.affiliation: Department of Cardiovascular Surgery, Kocaeli Derince Education and Research Hospital, Kocaeli.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Ata
authors.affiliation: Department of Cardiovascular Surgery, Kocaeli Derince Education and Research Hospital, Kocaeli.
authors.forename: Tamer
authors.initials: T
authors.lastname: Turk
mesh_terms: D000638:Amiodarone / Q000008:administration & dosage*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011292:Premedication / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; D000638:Amiodarone