Abstract
In 21 patients with acute coronary artery disease the influence of cardiac failure on the elimination of lidocaine (L) was evaluated by repeated serum level measurements during and after a therapeutic L-infusion. Lidocaine clearance (C1) was <8 ml/min/kg in 9 of 13 cases with congestive heart failure (CHF), while in 7 out of 8 patients without CHF C1-values were 8-12 ml/min/kg. Due to wide interindividual variability in the CHF group, however, mean values were not significantly different: 7.3±2.9 vs. 9.52±1.54 ml/min/kg (p>0.05). In 3 patients receiving a simultaneous nitroglycerine infusion C1 was >10 ml/min/kg despite clinical signs of CHF. The t 1/2 of L was significantly prolonged in patients with CHF: 4.29±2.14 vs. 2.43±0.58 h (p<0.05). It was not possible to determine individual L-dose requirements by bedside clinical examination alone. Serum level monitoring is therefore recommended in order to optimize L-therapy in patients with life-threatening arrhythmias, severe congestive heart failure and hypotension.
Translated title of the contribution | Slowing of lidocaine elimination and dose adjustment in patients with cardiac failure |
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Original language | German |
Pages (from-to) | 789-791 |
Number of pages | 3 |
Journal | Schweizerische Medizinische Wochenschrift |
Volume | 112 |
Issue number | 22 |
Publication status | Published - 1982 |
Externally published | Yes |