ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
COMPARISON OF PERIOPERATIVE MYOCARDIAL PROTECTION WITH BOLUS AND INFUSION LIDOCAINE AFTER CABG
Nursel ŞAHİN, Tülin AYDOĞDU TİTİZ, Zeki ERTUĞ, Meliha ERMAN, *Cengiz TÜRKAY, *İlhan GÖLBAŞI
Akdeniz Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı, Antalya

* Akdeniz Üniversitesi Tıp Fakültesi, Kalp Damar Cerrahisi Ana Bilim Dalı, Antalya

Background: We planned the usage of both bolus and infusion lidocaine in our study in CABG and in the efficiency of myocardial protection with serum Troponin-T (Tn-T) levels.

Methods: After ethic committee’s approval, 45 patients scheduled for an elective CABG were randomised to three groups (n = 15). First group (control) with standart cold crystalloid cardioplegia, 2. group with additional lidocaine bolus (1 mg/kg) and 3. group lidocaine infusion (20 µg/kg/min) before cardiac cannulation. Troponin-T, creatinin kinase (CK), CK-MB and lactic dehydrogenase were assessed before the operation and postoperative 6, 12, 24 and 48 hours. Twelve-lead electrocardiogram was recorded peroperative and repeated during the first 48 postoperative hours in parallel with biochemical analyses.

Results: Elevated circulating Tn-T, CK and lactic dehydrogenase levels were no significant between the groups. But the change of CK-MB level was significantly. Troponin-T and CK-MB changes with respect to control group were lower using lidocaine both 2 and 3. groups. Electrocardiographic changes were observed in 8 patients (60%) in first group, in 4 patients (26.6%) in the bolus lidocaine group and in 3 patients (20%) in the infusion lidocaine group.

Conclusion: Lidocaine infusion may be a useful adjunct to myocardial protection, as determined by the analysis of Tn-T and CK-MB.

Keywords : Coronary artery bypass grafting, myocardial protection, lidocaine, troponin
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