[Comparative studies on dose adjustment of intraoperative lidocaine therapy in heart failure patients]

From 10 patients with myocardial insufficiency arterial blood samples were taken, in order to study lidocaine plasma concentrations following reduced iv. bolus administration (0.5 mg/kg body weight) and subsequent infusion (2 mg/min). Drug concentrations were monitored by means of gas chromatography. The results obtained from the reduced loading dose of lidocaine were nearly identical to those from patients without myocardial insufficiency and an iv. bolus injection of 1 mg lidocaine/kg body weight. The reduced hepatic metabolism of lidocaine caused by manifest myocardial insufficiency requires a significantly reduced loading dose not exceeding the therapeutic range, even in intraoperative short-term use.