Comparison Between Lidocaine, Dexmedetomidine, and Their Combined Infusion in Subjects Undergoing Coronary Artery Bypass Graft

Samsung Medical Center

Status

Completed

Conditions

Blood Electrolyte Balance

Arrhythmia

Coronary Artery Bypass Graft

Unstable Angina

Dexmedetomidine

Lidocaine

Myocardial Injury

Treatments

Drug: Lidocaine infusion

Drug: Dexmedetomidine infusion

Study type

Interventional

Funder types

Other

Identifiers

NCT01688648

2012-07-098-001

Details and patient eligibility

About

The aim of the present study is to compare the antiarrhythmic and myocardial protective effect between lidocaine, dexmedetomidine, and their combined infusion in subjects undergoing coronary artery bypass graft.

Full description

Lidocaine has been reported to have an antiarrhythmic and myocardial protective effect. A previous study has reported that low-dose lidocaine infusion can decrease the incidence of ventricular fibrillation and tachycardia during the first 24 hours after coronary artery bypass graft (CABG). A recent study also reported that the lidocaine infusion during CABG could decrease the myocardial injury by measuring the CK-MB and Troponin-I blood level.

Dexmedetomidine is an alpha-2 agonist and reduces the sympathetic tone and neuroendocrine stress response. Dexmedetomidine was reported to have a cardioprotective effect by a previous animal study. However, there was no clinical study evaluating the cardioprotective effect of dexmedetomidine.

Therefore, we are trying to evaluate and compare the antiarrhythmic and myocardial protective effect between lidocaine, dexmedetomidine, and their combined infusion in subjects undergoing coronary artery bypass graft.

Enrollment

160 patients

Sex

All

Ages

20 to 80 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Those undergoing off-pump coronary artery bypass graft during the study period in Samsung Medical Center

Exclusion criteria

Any patients with plasma aldosterone, or glucocorticoid disorder including primary hyperaldosteronism, renovascular hypertension, rennin-secreting tumor, salt-wasting renal disease, Cushing syndrome
Patients with recent exogenous steroid administration or previous diuretics therapy
Patients with recent myocardial infarction
Those undergoing unplanned cardiopulmonary bypass during the surgery

Trial design

160 participants in 4 patient groups

Lidocaine group

Experimental group

Description:

a bolus dose of lidocaine 1.5 mg/kg after anesthetic induction with following lidocaine infusion with 2 mg/kg/hr during the surgery and same dose during postoperative 24 hour in ICU.

Treatment:

Drug: Lidocaine infusion

Dexmedetomidine group

Experimental group

Description:

Dexmedetomidine infusion during anesthetic induction with 0.2 mcg/kg/hr followed by 0.3 \~ 0.7 mcg/kg/hr during the surgery

Treatment:

Drug: Dexmedetomidine infusion

Combined infusion group

Experimental group

Description:

Combined lidocaine and dexmedetomidine infusion with the dose specified in single infusion group