Audit of lidocaine use

An audit of lidocaine use in critical-care areas of a hospital is reported. Fifty adult patients for whom lidocaine was prescribed were admitted to the study; 31 were men. Using process, outcome, and complication criteria, the investigators reviewed the patients' medical records. If a deviation from accepted criteria was found, a medical audit committee (composed of physicians) reviewed the records and decided if the deviation was warranted. The audit results showed good compliance with the established criteria. Some minimal deficiencies were found in how lidocaine administration was initiated (6%), when a constant infusion was begun (12%), the rate of constant infusion (2%), and converting to oral therapy (2%). There was substantial deviation from criteria when ventricular arrhythmias recurred during lidocaine therapy. No major deficiencies in management of lidocaine toxicity were found. Recommendations that resulted from the audit are discussed.