Hemodynamic Effects of Lidocaine in Patients with Heart Disease

Abstract

The intravenous administration of 50 mg of lidocaine as a single bolus to four patients with heart disease did not result in a significant change in cardiac output or left ventricular end-diastolic pressure (LVEDP). Two patients had moderate decrease in systemic arterial pressure which was not accompanied by symptoms, was of short duration, and did not require therapeutic intervention. Left ventricular function, as assessed by the relationship of changes in stroke volume index (SVI) and stroke work index (SWI) to changes in LVEDP, was not significantly affected nor was the maximum rate of rise of left ventricular pressure (dp/dt). The intravenous injection of 100 mg of lidocaine into eight additional patients with heart disease did not produce a statistically significant change in any of these hemodynamic variables when compared to their respective control values. Examination of individual responses, however, revealed that some depression of left ventricular function occurred in at least three and probably four of these patients. Nevertheless, this depression of myocardial function was not of sufficient magnitude to produce symptoms or reduce the cardiac output and generally did not result in an inordinate increase in LVEDP. It is concluded that 100 mg or less of lidocaine injected intravenously has remarkably few, if any, adverse hemodynamic effects of clinical significance in man.