[Lidocaine elimination and dose adjustment in acute heart infarct and heart insufficiency]. / Die Lidocain-Elimination und -Dosisanpassung bei akutem Herzinfarkt und Herzinsuffizienz.

ABSTRACT

In 40 patients with an acute myocardial infarction a prolonged lidocaine infusion was indicated. The dosage of lidocain was done according to the body-weight. Patients suffering from a heart insufficiency received the anti-arrhythmic drug with a reduced dose referring to the degree of severity. The lidocaine-plasma content was determined by means of a gas-chromatographic method. Furthermore, the half-value time, the clearance and the distribution coefficient were computed. Despite the reduction of the dose the plasma contents were highest in patients with manifest heart insufficiency. As we expected, the half-value time was shorter in the patients with infarction without heart insufficiency than in the patients with manifest heart insufficiency. The behaviour of the total clearance was analogous in the adequate groups of patients. The lidocain dosage performed which referred to more recent investigations of the behaviour of the half-value time after prolonged infusion is regarded as more precisely in comparison to the previous proposals. Corresponding to the findings got, a dosage scheme is given for patients with myocardial infarction and heart insufficiency, which should allow a secure and effective treatment.