Prophylactic lidocaine in the early phase of suspected myocardial infarction

Dunn, Heather; McComb, Jonathan; Kinney, C.D.; Campbell, Norman P.S.; Shanks, R. G.; MacKenzie, Gilbert; Adgey, A. A. J.

doi:10.1016/0002-8703(85)90156-5

Cited by 45 publications

(6 citation statements)

References 45 publications

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“…590 There were 2 studies that showed harm (LOE 1). 580,592 One trial showed a statistically significant benefit in decreasing the incidence of VT using sotalol (LOE 1). 594 Three studies were neutral with respect to tocainide and disopyramide (LOE 1), 582 mexilitine (LOE 1), 579 and tocainamide (LOE 1).…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 9: Acute Coronary Syndromes

Bossaert

O’Connor²,

Arntz³

et al. 2010

Circulation

103

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These experts reviewed 25 topics related to the acute initial management of acute coronary syndrome (ACS), which was further categorized as unstable angina, non-ST-elevation MI (UA/NSTEMI) and ST-elevation MI (STEMI). Topics were identified based on previous recommendations, emerging science, and clinical importance, using an iterative writing process involving all Task Force members. The Task Force reviewed the evidence specifically related to diagnosis and treatment of ACS in the out-ofhospital setting and the first hours of care in the in-hospital setting, typically in the emergency department (ED). The evidence review took place over several years, with ongoing refinement of recommendations being made as new evidence was published. The purpose of the review was to generate current, evidence-based treatment recommendations for healthcare providers who serve as the initial point of contact for patients with signs and symptoms suggestive of ACS.The following is a summary of the most important changes in recommendations for diagnosis and treatment of ACS since the last ILCOR review in 2005. 1,2• The history and physical examination, initial ECG, and initial serum biomarkers, even when used in combination, cannot be used to reliably exclude ACS in the prehospital and ED settings.• In contrast, chest pain observation protocols are useful in identifying patients with suspected ACS and patients who require admission or may be referred for provocative testing for coronary artery disease (CAD) to identify reversible ischemia. Such strategies also reduce cost by reducing unnecessary hospital admissions and improve patient safety through more accurate identification of NSTEMI and STEMI.• The acquisition of a prehospital 12-lead ECG is essential for identification of STEMI patients before hospital arrival and should be used in conjunction with pre-arrival hospital notification and concurrent activation of the catheter laboratory.• Nonphysicians can be trained to independently interpret 12-lead ECGs for the purpose of identifying patients with STEMI, provided that appropriate and reliable STEMI criteria are used. This skill is of particular value in the prehospital setting where paramedics may independently identify STEMI, thus mitigating over-reliance on ECG transmission.• Computer-assisted ECG interpretation can be used to increase diagnostic accuracy of STEMI diagnosis when used alone or in combination with ECG interpretation by a trained healthcare provider.• STEMI systems of care can be implemented to improve the time to treatment. The following measures have been shown to reduce the time to primary percutaneous coronary intervention (PPCI): institutional commitment, use of a team-based approach, arranging single-call activation of the catheterization laboratory by the emergency physician or prehospital provider, requiring the catheterization laboratory to be ready in 20 minutes, having an experienced cardiologist always available, and providing real-time data feedback.• Intravenous (IV) ␤-blockers should not be give...

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Section: Consensus On Sciencementioning

confidence: 99%

Part 9: Acute Coronary Syndromes

Bossaert

O’Connor²,

Arntz³

et al. 2010

Circulation

103

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“…Results from the literature review on unwanted effects of i.v. lidocaine treatment in adults are presented in Table 2, including only case series (9, 10, 14–63). It includes 50 series and around 6000 patients treated for different reasons: surgical patients (for anaesthesia), pain and headache patients (for analgesia), cardiac patients (for ventricular arrhythmias), epileptic patients (for seizure control) and also healthy volunteers in experimental conditions.…”

Section: Resultsmentioning

confidence: 99%

Neuropsychiatric Side-Effects of Lidocaine: Examples from the Treatment of Headache and a Review

Gil‐Gouveia

Goadsby

2009

Cephalalgia

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Lidocaine has been used in treatment of patients with refractory headache. Personal observations of neuropsychiatric toxicity in these patients led us to review our cases and the literature systematically for lidocaine side-effects, especially neuropsychiatric symptoms. In our series of 20 patients, side-effects were observed in all, the most frequent being neuropsychiatric (75%) and cardiological (50%). When reviewing published series on intravenous lidocaine use, reports of side-effects range from 0 to 100%, with neuropsychiatric symptoms being reported in 1.8-100%. Thirty-six case reports of lidocaine-induced psychiatric symptoms were also analysed. Psychiatric symptoms of toxicity were similar in most patients, despite their differing ages, pathologies, co-therapies and lidocaine dosages. In conclusion, lidocaine neuropsychiatric toxicity has a well-recognized stereotypical clinical presentation that is probably unrecognized in headache series. As lidocaine represents an emerging alternative therapy in headache, particularly in short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing, clinicians and patients should be aware of the extent of this problem.

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“…There is little evidence to suggest that the prophylactic use of antiarrhythmics improves outcomes in patients with ACS 38–41 . The prophylactic use of antiarrhythmic agents hence is not recommended.…”

Section: Antiplatelet and Anticoagulant Therapymentioning

confidence: 99%

Acute Coronary Syndromes: Initial Medical Therapy. ARC and NZRC Guideline 2011

2011

Emerg Medicine Australasia

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Prophylactic lidocaine in the early phase of suspected myocardial infarction

Cited by 45 publications

References 45 publications

Part 9: Acute Coronary Syndromes

Part 9: Acute Coronary Syndromes

Neuropsychiatric Side-Effects of Lidocaine: Examples from the Treatment of Headache and a Review

Acute Coronary Syndromes: Initial Medical Therapy. ARC and NZRC Guideline 2011

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