title: The Use of Lidocaine Containing Cardioplegia in Surgery for Adult Acquired Heart Disease.
abstract: BACKGROUND
  Del Nido cardioplegia, a crystalloid-based solution with lidocaine as a key element, is given as a single dose and has been used successfully in congenital cardiac surgery.
  
  
  OBJECTIVE
  We retrospectively compared a lidocaine containing "modified del Nido" solution with our standard whole blood cardioplegia to investigate its safety and efficacy in adult cardiac surgery.
  
  
  METHODS
  From June 1, 2013 to December 30, 2013, we used a single dose of lidocaine containing cardioplegia (LC group) in 92 consecutive operations. Propensity matching analysis was undertaken to compare the outcomes of such patients with those who underwent their surgery by the same surgeon using standard whole blood cardioplegia (WB group), n = 396. Propensity score matching yielded 79 pairs of patients.
  
  
  RESULTS
  After propensity matching, LC and WB groups were similar in baseline operative characteristics including cross-clamp time (LC: 65 minutes [range 54 to 89] vs. WB: 70 minutes [54 to 86], p = 0.993). Postoperative outcomes were similar including inotropic requirements (30.4% [24/72] vs. 25.3% [20/72], p < 0.60), median ventilation time (4.7 hours vs. 5.3, p < 0.74) and median length of stay was seven days for both groups (p < 0.82). Despite higher median postoperative, 24-hour CK-MB levels LC group (LC:22.3 ng/ml, range [15.6 to 40.3] vs. WB:18.4 ng/ml [13.9 to 28.2], p = 0.040), operative and one-year mortality were comparable among study groups (both p > 0.798).
  
  
  CONCLUSIONS
  Lidocaine containing cardioplegia appears to be safe in adults undergoing cardiac procedure when administered for the first 60 minutes of aortic cross clamping. Higher CK-MB levels did not translate into adverse clinical outcomes.
authors.affiliation: Division of Cardiac Surgery, The Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Maroun
authors.initials: M
authors.lastname: Yammine
authors.affiliation: Division of Cardiac Surgery, The Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Neely
authors.affiliation: Division of Cardiac Surgery, The Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Dan
authors.initials: D
authors.lastname: Loberman
authors.affiliation: Division of Cardiac Surgery, The Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Taufiek Konrad
authors.initials: TK
authors.lastname: Rajab
authors.affiliation: Division of Cardiac Surgery, The Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Amardeep
authors.initials: A
authors.lastname: Grewal
authors.affiliation: Division of Cardiac Surgery, The Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Siobhan
authors.initials: S
authors.lastname: McGurk
authors.affiliation: Division of Cardiac Surgery, The Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Daniel
authors.initials: D
authors.lastname: Fitzgerald
authors.affiliation: Division of Cardiac Surgery, The Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Sary F
authors.initials: SF
authors.lastname: Aranki
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures; D052279:Creatine Kinase, MB Form / Q000032:analysis; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006331:Heart Diseases / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017680:Potassium Compounds / Q000008:administration & dosage*; D057216:Propensity Score; D012189:Retrospective Studies; D013525:Surgical Instruments; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D017680:Potassium Compounds; C018369:potassium cardioplegic solution; D008012:Lidocaine; D052279:Creatine Kinase, MB Form