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An open-label, non-inferiority randomized controlled trial of lidocAine Versus Opioids In MyocarDial Infarction study
Himawan Fernando1, Catherine Milne2, Ziad Nehme2
1Department of Cardiology, Alfred Hospital, Melbourne, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia; Monash University, Melbourne, Australia.
Contemporary Clinical Trials
|April 24, 2021
Summary
This study compares intravenous lidocaine and fentanyl for chest pain in heart attack patients. Lidocaine may offer a safer alternative, avoiding opioid interactions with crucial antiplatelet medications.
Area of Science:
- Cardiology
- Emergency Medicine
- Pharmacology
Background:
- Opioids can reduce the effectiveness of P2Y12 inhibitors, delaying antiplatelet effects.
- This interaction poses a risk in managing acute coronary syndromes.
- Alternative analgesics are being explored to mitigate this interaction.
Purpose of the Study:
- To compare the analgesic efficacy and safety of intravenous lidocaine versus fentanyl.
- To evaluate lidocaine as an alternative to opioids for chest pain in ST-elevation myocardial infarction (STEMI).
- To assess infarct size using cardiac MRI as a secondary endpoint.
Main Methods:
- A phase II, pre-hospital, randomized controlled trial (AVOID-2).
- 300 adult patients with suspected STEMI were enrolled.
- Intravenous lidocaine was compared against intravenous fentanyl for pain relief and safety.
Main Results:
- (Study results are pending as this is a protocol description)
Conclusions:
- Alternative analgesics are crucial for acute coronary syndrome management.
- Addressing the opioid-P2Y12 inhibitor interaction is vital.
- Trial results will inform international emergency cardiac care protocols.
