title: A comparison among infusion of lidocaine and dexmedetomidine alone and in combination in subjects undergoing coronary artery bypass graft: a randomized trial.
abstract: BACKGROUND
  Previous studies have reported the cardioprotective effect of dexmedetomidine and lidocaine. We compared the effect of lidocaine and dexmedetomidine infusion during off-pump coronary artery bypass graft (OPCAB).
  
  
  METHODS
  153 patients undergoing OPCAB were enrolled. The lidocaine group (n=36, Group LIDO) received an infusion of lidocaine 2 mg/kg/h after bolus 1.5 mg/kg; the dexmedetomidine group (n=40, Group DEX) received dexmedetomidine 0.3-0.7 μg/kg/h; the combined group (n=39, Group Combined) received infusion of both drugs; and the control group (n=38) received nothing. We measured serum creatinine kinase-myocardial band (CK-MB) and cardiac troponin I (cTnI) concentration before and immediately after the surgery, postoperative day (POD)#1 and #2. The complication rate and clinical outcomes were compared.
  
  
  RESULTS
  The concentration of cTnI was significantly lower in the Group LIDO and Group Combined than the control group on POD#2. The concentration of CK-MB was significantly lower in the Group LIDO and Group Combined compared to the control group on POD#1 and #2 [CK-MB on POD#1: 7.67 (5.78-11.92) vs. 7.18 (5.01-11.72) vs. 13.19 (6.85-23.87) in the Group LIDO, combined and control, respectively, Group LIDO vs. control: p=0.003, Group Combined vs. control: p=0.015]. The AUC of CK-MB was significantly lower in the Group LIDO and Group Combined than the control group. However, clinical variables including complication rate, ICU stay and one-year mortality were not different.
  
  
  CONCLUSIONS
  Lidocaine infused at 2 mg/kg/h, but not dexmedetomidine infused at 0.3-0.7 μg/kg/h reduced postoperative myocardial injury marker levels compared with the control group. However, no other clinical benefits were observed.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea; Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyo-Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea. Electronic address: wonhokim.ane@gmail.com.
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Gahyun
authors.initials: G
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Eunhee
authors.initials: E
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Mi-Hye
authors.initials: MH
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Byung Seop
authors.initials: BS
authors.lastname: Shin
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Woo Seog
authors.initials: WS
authors.lastname: Sim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Chung Su
authors.initials: CS
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun Sung
authors.initials: HS
authors.lastname: Cho
mesh_terms: D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016037:Single-Blind Method; D019210:Troponin I
chemical_list: D000779:Anesthetics, Local; D015415:Biomarkers; D006993:Hypnotics and Sedatives; D019210:Troponin I; D020927:Dexmedetomidine; D008012:Lidocaine
keywords: Anesthesia; Coronary artery bypass graft; Dexmedetomidine; Lidocaine; Myocardial injury