Amiodarone versus lidocaine for the prevention of reperfusion ventricular fibrillation: A randomized clinical trial

BACKGROUND: Reperfusion ventricular fibrillation after aortic cross clamp is one of the important complications of open cardiac surgery and its prevention could reduce myocardial injuries. This study aimed to evaluate the efficacy of single dose of amiodarone or lidocaine by the way of pump circuit three minutes before aortic cross clamp release and compare the results with normal saline as placebo in a randomized double blinded controlled trial. METHODS: One hundred fifty patients scheduled for first time elective coronary artery bypass graft surgery were randomly assigned to receive either single dose of amiodarone (۱۵۰ mg), lidocaine (۱۰۰ mg), or normal saline (۵ ml) three minutes before aortic cross clamp release. The incidence of ventricular fibrillation and the need for reuse of drug were compared between these groups by chi-square, Student’s t-test, Mann-Whitney test, and One-way ANOVA. SPSS software was used for statistical analysis. RESULTS: The incidence of ventricular fibrillation is higher in the placebo group (۱۵.۹%) compare to lidocaine (۱۱.۸%) and amiodarone (۸.۹%) groups; however, there was no statistical difference among the three groups (P = ۰.۴۱). Moreover, the reuse of amiodarone (۲۲.۷%) was statistically higher (P < ۰.۰۵) than lidocaine (۵.۹%). CONCLUSION: This study showed no difference among lidocaine, amiodarone, and placebo in preventing ventricular fibrillation after aortic cross clamp release.   Keywords: Amiodarone, Lidocaine, Ischemia Reperfusion Injury, Ventricular Fibrilation, Randomized Controlled Trial