Comparison of Procaine and Lidocaine in Cardioplegia for Preventing Ventricular Fibrillation After Aortic Cross-Clamping Release in Coronary Artery Bypass Graft
Keywords:
Coronary artery bypass graft, Lidocaine hydrochloride, Procaine hydrochloride, Ventricular fibrillationAbstract
Background: The use of procaine hydrochloride in cardioplegia has been discontinued due to challenges importing the product from outside the country despite its crucial role in preserving myocardium during heart surgery. However, lidocaine hydrochloride, an anti-arrhythmic medication, functions similarly to procaine hydrochloride. Both medications are compared regarding their effectiveness in preventing ventricular fibrillation, the most common type of heart arrhythmia, after releasing the aortic cross-clamp in cardiac surgery.
Materials and Methods: This is a retrospective study in which data were collected from medical records of patients who were operated on with coronary artery bypass grafts between May 2017 and August 2023. Patient demographics and early outcomes between the two groups were analyzed.
Results: A total of 328 patients who operated on CABG were divided into 2 groups, respectively. Group one was a group of cardioplegia solutions with procaine hydrochloride, and group two was a group of cardioplegia solutions with lidocaine hydrochloride. Most participants were 64.19 years old and 64.24 years old, respectively. The duration of the aortic cross-clamp was significantly different between the two groups, with durations of 76.06 minutes and 87.79 minutes, respectively, showing a p-value of less than 0.01 in statistical analysis. Following the release of aortic cross-clamping, the occurrence of ventricular fibrillation was observed in 37 patients (43%) in the first group and 49 patients (56.9%) in the second group, with no significant difference noted. Subsequent to defibrillation at 10 joules, there were 21 patients (24.4%) in the first group and 13 patients (15.1%) in the second group, indicating a significant difference. Additionally, no significant difference was observed in the duration of the CCU stay between both groups.
Conclusion: Cardioplegic solution containing lidocaine hydrochloride provides the same clinical result as procaine hydrochloride in coronary artery bypass grafting surgery.
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