Prophylactic use of a lidocaine constant rate infusion versus saline in dogs undergoing balloon valvuloplasty for management of pulmonic stenosis: A randomized control trial |
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| Institution: | 1. Willows Veterinary Centre and Referral Service, Solihull, UK;2. Paragon Veterinary Referrals, Wakefield, UK;3. Virtual Veterinary Specialists, Middlesex, UK;4. Ela trabalha em Plakentia Veterinary Clinic, Ag. Paraskevi, Greece;5. Waltham Petcare Science Institute, Leicestershire, UK;1. Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA;2. Institute of Bioinformatics, Franklin College of Arts and Sciences, University of Georgia, Athens, GA, USA;3. Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA;4. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, USA;1. Clinical Unit of Anaesthesiology and Perioperative Intensive Care, University of Veterinary Medicine Vienna, Vienna, Austria;2. Unit of Ethics and Human-Animal Studies, University of Veterinary Medicine Vienna, Medical University of Vienna, University of Vienna, Vienna, Austria;1. Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA;2. Innovative Veterinary Medicine, Ponte Vedra, FL, USA;3. Department of Statistics, College of Arts and Science, University of Missouri, Columbia, MO, USA;4. Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA;1. Dick White Referrals, Station Farm, Six Mile Bottom, Cambridgeshire, UK;2. Hospital Veterinari Glòries, Barcelona, Spain;3. Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, FL, USA |
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| Abstract: | ObjectiveTo evaluate the effect of a prophylactic lidocaine constant rate infusion (CRI) on the incidence and malignancy of catheter-induced ventricular ectopic complexes (VECs) during balloon valvuloplasty for management of pulmonic stenosis in dogs.Study designSingle-centre, prospective, randomized study.AnimalsClient-owned dogs (n = 70) with pulmonic stenosis.MethodsDogs were randomly assigned to one of two anaesthetic protocols: administration of lidocaine 2 mg kg–1 bolus followed by a CRI (50 μg kg–1 minute–1; group LD) or a saline placebo (group SL) during balloon valvuloplasty. All dogs were premedicated with methadone (0.3 mg kg–1) intramuscularly and a digital three-lead Holter monitor was applied. Anaesthetic co-induction was performed with administration of alfaxalone (2 mg kg–1) and diazepam (0.4 mg kg–1), and anaesthesia was maintained with isoflurane vaporised in 100% oxygen. CRIs were started on positioning of the dog in theatre and discontinued as the last vascular catheter was removed from the heart. All dogs recovered well and were discharged 24 hours postoperatively. Blinded Holter analysis was performed by an external veterinary cardiologist using commercially available dedicated analysis software; p < 0.05.ResultsOf the 70 dogs enrolled in the study, 61 were included in the final analysis: 31 in group LD and 30 in group SL.There was no significant difference between sinus beats (p = 0.227) or VECs (p = 0.519) between groups. In group LD, 19/31 (61.3%) dogs had a maximum ventricular rate ≥250 units and 20/30 (66.7%) dogs in group SL (p = 0.791).Conclusion and clinical relevanceIn this study, the use of a prophylactic lidocaine bolus followed by CRI in dogs undergoing balloon valvuloplasty for management of pulmonic stenosis did not significantly decrease the incidence nor the malignancy of VECs during right heart catheterization compared with a saline CRI. |
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| Keywords: | arrhythmias balloon valvuloplasty electrocardiogram lidocaine pulmonic stenosis |
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