Practical guidelines for the use of lidocaine. Prevention and treatment of cardiac arrhythmias.

ALTHOUGH lidocaine hydrochloride was synthesized as a local anesthetic drug in 1943, its antiarrhythmic property was not recognized until the late 1950s, when anesthesiologists used the drug in the operating room for treating ventricular arrhythmias that occurred during the course of open heart surgery. 1 In 1963, a detailed study 2 reported the comparison of lidocaine with procainamide for treating intraoperative and postoperative ventricular arrhythmias in patients undergoing cardiac surgery. This study demonstrated that lidocaine was safe, highly effective, and preferable to procainamide for such arrhythmias. With the development of the coronary care unit during the 1960s, lidocaine was found to be an important agent in controlling life-threatening arrhythmias, 3 and in 1967, its use for the treatment of less serious ventricular rhythm disturbances, which frequently herald the development of life-threatening arrhythmias, was proposed. 4 Subsequently, it gained general acceptance in the coronary care unit for both treating and preventing

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