Comparison of Amiodarone with Combined Doses of Magnesium Sulphate and Lidocaine for Prevention of Ventricular Fibrillation Following Coronary Clamp Release During Coronary Artery Bypass Graft Surgery

Objective: To compare the effects of amiodarone with effects of combined doses of magnesium sulphate and lidocaine for prevention of ventricular fibrillation following coronary clamp release during (coronary artery bypass grafting) CABG. Study Design: Comparative cross sectional study. Place...

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Main Authors: Muhammad Adnan Akram, Mehwish Naseer, Fakher-e- Fayaz, Hana Khurshid, Nasir Ali, Imtiaz Ahmed Chaudhry
Format: Article
Language:English
Published: Army Medical College Rawalpindi 2022-11-01
Series:Pakistan Armed Forces Medical Journal
Subjects:
Online Access:https://pafmj.org/index.php/PAFMJ/article/view/9554
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author Muhammad Adnan Akram
Mehwish Naseer
Fakher-e- Fayaz
Hana Khurshid
Nasir Ali
Imtiaz Ahmed Chaudhry
author_facet Muhammad Adnan Akram
Mehwish Naseer
Fakher-e- Fayaz
Hana Khurshid
Nasir Ali
Imtiaz Ahmed Chaudhry
author_sort Muhammad Adnan Akram
collection DOAJ
description Objective: To compare the effects of amiodarone with effects of combined doses of magnesium sulphate and lidocaine for prevention of ventricular fibrillation following coronary clamp release during (coronary artery bypass grafting) CABG. Study Design: Comparative cross sectional study. Place and Duration of Study: Army Cardiac Centre, Lahore Pakistan, from Jun 2021 to Dec 2021. Methodology: One hundred patients who reported at Army Cardiac Centre Lahore, Pakistan for coronary artery bypass grafting surgery, were involved in comparative study. Patients satisfying the inclusion criteria were allocated into the LM(Lidocaine Magnesium) and A (Amiodarone) groups. Following aortic cross clamp release, the incidence of ventricular fibrillation (VF) and other arrhythmias was calculated in first 30 minutes and up to 24 hours later. The ionotropic agent used was epinephrine at a rate of 0.05 to 0.1 micrograms/kg/minute. Within 15 minutes of anesthetic induction and 15 minutes after the CPB pump was removed, hemodynamic parameters were assessed and recorded. Results: Arrhythmias within 30 minutes and up to 24 hours after aortic cross clamp ACC release in A and LM group were compared. The difference between two groups, having arrhythmias and no arrhythmias was statistically insignificant (p≥0.050) except VF up to 24 hours after ACC release. The highest voltage for defibrillation was used in Group-A n=20 (40.0%) and n=27 (54.0%) in L.M group, (p=0.004). The average electrical defibrillations in group-A was less than that of group L.M,(p=0.000). While, the use of ionotropic agent was almost equal in both the groups, (p=0.975). Conclusion: Overall, the amiodarone group had a decreased incidence of VF when the ACC was released, while the difference was not statistically significant.
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spelling doaj.art-2a13847a99764996898cdbf096ec93562023-01-31T08:22:54ZengArmy Medical College RawalpindiPakistan Armed Forces Medical Journal0030-96482411-88422022-11-0172SUPPL-310.51253/pafmj.v72iSUPPL-3.9554Comparison of Amiodarone with Combined Doses of Magnesium Sulphate and Lidocaine for Prevention of Ventricular Fibrillation Following Coronary Clamp Release During Coronary Artery Bypass Graft SurgeryMuhammad Adnan Akram0Mehwish Naseer1Fakher-e- Fayaz2Hana Khurshid3Nasir Ali4Imtiaz Ahmed Chaudhry5Armed Forces Institute of Cardiology/National Institute of Heart Diseases/(AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi PakistanArmy Cardiac Centre, Lahore, PakistanArmy Cardiac Centre, Lahore, PakistanHameed Latif Hospital, Lahore, PakistanArmed Forces Institute of Cardiology/National Institute of Heart Diseases/(AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi PakistanArmed Forces Institute of Cardiology/National Institute of Heart Diseases/(AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan Objective: To compare the effects of amiodarone with effects of combined doses of magnesium sulphate and lidocaine for prevention of ventricular fibrillation following coronary clamp release during (coronary artery bypass grafting) CABG. Study Design: Comparative cross sectional study. Place and Duration of Study: Army Cardiac Centre, Lahore Pakistan, from Jun 2021 to Dec 2021. Methodology: One hundred patients who reported at Army Cardiac Centre Lahore, Pakistan for coronary artery bypass grafting surgery, were involved in comparative study. Patients satisfying the inclusion criteria were allocated into the LM(Lidocaine Magnesium) and A (Amiodarone) groups. Following aortic cross clamp release, the incidence of ventricular fibrillation (VF) and other arrhythmias was calculated in first 30 minutes and up to 24 hours later. The ionotropic agent used was epinephrine at a rate of 0.05 to 0.1 micrograms/kg/minute. Within 15 minutes of anesthetic induction and 15 minutes after the CPB pump was removed, hemodynamic parameters were assessed and recorded. Results: Arrhythmias within 30 minutes and up to 24 hours after aortic cross clamp ACC release in A and LM group were compared. The difference between two groups, having arrhythmias and no arrhythmias was statistically insignificant (p≥0.050) except VF up to 24 hours after ACC release. The highest voltage for defibrillation was used in Group-A n=20 (40.0%) and n=27 (54.0%) in L.M group, (p=0.004). The average electrical defibrillations in group-A was less than that of group L.M,(p=0.000). While, the use of ionotropic agent was almost equal in both the groups, (p=0.975). Conclusion: Overall, the amiodarone group had a decreased incidence of VF when the ACC was released, while the difference was not statistically significant. https://pafmj.org/index.php/PAFMJ/article/view/9554AmiodaroneArrhythmiasCardiopulmonary bypassCoronary artery bypass grafting (CABG)LidocaineMagnesium sulphate
spellingShingle Muhammad Adnan Akram
Mehwish Naseer
Fakher-e- Fayaz
Hana Khurshid
Nasir Ali
Imtiaz Ahmed Chaudhry
Comparison of Amiodarone with Combined Doses of Magnesium Sulphate and Lidocaine for Prevention of Ventricular Fibrillation Following Coronary Clamp Release During Coronary Artery Bypass Graft Surgery
Pakistan Armed Forces Medical Journal
Amiodarone
Arrhythmias
Cardiopulmonary bypass
Coronary artery bypass grafting (CABG)
Lidocaine
Magnesium sulphate
title Comparison of Amiodarone with Combined Doses of Magnesium Sulphate and Lidocaine for Prevention of Ventricular Fibrillation Following Coronary Clamp Release During Coronary Artery Bypass Graft Surgery
title_full Comparison of Amiodarone with Combined Doses of Magnesium Sulphate and Lidocaine for Prevention of Ventricular Fibrillation Following Coronary Clamp Release During Coronary Artery Bypass Graft Surgery
title_fullStr Comparison of Amiodarone with Combined Doses of Magnesium Sulphate and Lidocaine for Prevention of Ventricular Fibrillation Following Coronary Clamp Release During Coronary Artery Bypass Graft Surgery
title_full_unstemmed Comparison of Amiodarone with Combined Doses of Magnesium Sulphate and Lidocaine for Prevention of Ventricular Fibrillation Following Coronary Clamp Release During Coronary Artery Bypass Graft Surgery
title_short Comparison of Amiodarone with Combined Doses of Magnesium Sulphate and Lidocaine for Prevention of Ventricular Fibrillation Following Coronary Clamp Release During Coronary Artery Bypass Graft Surgery
title_sort comparison of amiodarone with combined doses of magnesium sulphate and lidocaine for prevention of ventricular fibrillation following coronary clamp release during coronary artery bypass graft surgery
topic Amiodarone
Arrhythmias
Cardiopulmonary bypass
Coronary artery bypass grafting (CABG)
Lidocaine
Magnesium sulphate
url https://pafmj.org/index.php/PAFMJ/article/view/9554
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