TY - JOUR T1 - MEta-analytic evidence against prophylactic use of lidocaine in acute myocardial infarction AU - Hine LK, Laird N, Hewitt P, Chalmers TC Y1 - 1989/12/01 N1 - 10.1001/archinte.1989.00390120056011 JO - Archives of Internal Medicine SP - 2694 EP - 2698 VL - 149 IS - 12 N2 - • Although lidocaine prophylaxis reduces the incidence of ventricular fibrillation during acute myocardial infarction (AMI), randomized control trials (RCTs) have not demonstrated any significant mortality effect of this therapy. We conducted a meta-analysis of 14 RCTs of lidocaine prophylaxis during AMI to detect any mortality effect. Six prehospital- and eight hospital-phase RCTs that randomized totals of 7656 and 1407 patients, respectively, were selected and reviewed in a blinded fashion. Mortality data were evaluated according to therapy type, reporting interval, and patient category. The prehospital-phase RCTs showed no meaningful mortality effect (risk difference, 0.0184; 95% confidence interval, −0.048 to +0.012). The hospital-phase RCTs showed a statistically significant increase in mortality during the treatment period for lidocaine recipients (risk difference, 0.029; 95% confidence interval, +0.004 to +0.055). These results confirm that lidocaine administered to monitored patients during the prehospital phase of AMI will not reduce mortality by a clinically important amount and suggest that lidocaine administered in the hospital phase of monitored, uncomplicated AMI may increase mortality among recipients with proved AMI.(Arch Intern Med. 1989;149:2694-2698) SN - 0003-9926 M3 - doi: 10.1001/archinte.1989.00390120056011 UR - http://dx.doi.org/10.1001/archinte.1989.00390120056011 ER -