COMPARISON BETWEEN THE EFFECT OF AMIODARONE AND LIDOCAINE WITH MAGNESIUM SULFATE ON OCCURRENCE OF REPERFUSION VENTRICULAR FIBRILLATION AFTER AORTIC CROSS CLAMP RELEASE ON AORTIC VALVE SURGERY.

Background:Reperfusion ventricular fibrillation (VF) after aortic cross-clamp (ACC) release is one of the most common complications after Aortic valve surgery. Materials and methods:Eighty seven patients who had undergone Aortic valve surgery were assigned randomly to three groups (29 patients each). The lidocaine group received lidocaine with magnesium sulfate (mgso4) (100 mg lidocaine and 2g mgso4) in 25 ml isotonic saline, the amiodarone group received (300 mg amiodarone) diluted in 25 ml of an isotonic saline, and the control group received 25 ml normal saline by a pump circuit 3 min before ACC release. Anesthetic management, weaning protocol from cardiopulmonary bypass, were standardized. All the patients were monitored after the release of ACC and VF were recorded. Results:Incidence of VF after release of ACC was lower in the lidocaine with mgso4 group compared with the amiodarone and control group [6 (20.7%), 8 (27.6%) vs. 12 (41.4%)] but there was no statistically significant difference between all groups (P = 0.215). Also, the incidence of an atrioventricular block and bradycardia after release ACC was higher in the lidocaine mgso4 group compared with the amiodarone and control groups [7 (24.1%) vs. 4 (13.8%) and 3 (10.3%), respectively)] but there was no statistically significant difference between all groups (P = 0.331). Conclusion:The administration of lidocaine with mgso4 before the release of ACC reduced the incidence of VF. However, the administration of Lidocaine with mgso4 was associated with more transient atrioventricular block.