Lidocaine Intramuscularly in Acute Myocardial Infarction

Two hundred milligrams of lidocaine hydrochloride was given intramuscularly for controlling ventricular premature beats in 40 patients continuously monitored in an intensive care unit. In 14 patients, serum levels were determined by gas chromatographic technique. The treatment abolished premature ventricular beats in 30 of the 40 patients. Eight of the failures had persistent premature ventricular beats over a long period before admission to hospital. Serum levels and clinical results showed that effective drug concentrations were reached between 15 to 30 minutes after injection and that therapeutic levels were maintained for at least 60 minutes. It is suggested that lidocaine should be given intramuscularly to patients suffering an acute myocardial infarction before they are moved to hospital to prevent serious ventricular arrhythmias during the prehospital phase. Continuous cardiac monitoringtogether with the use of anti-arrhythmic drugs has bee