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lignocaine Vs. Amiodarone


chrispara

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Nate

just FYI talk to your suppliers, we use both here and both are in prefilled syringes.

We just stopped carrying it...only a few of us even used it. ETA to ER anywhere in the City is 5 minutes at the most. (Unless an airplane crashed in the middle of the road.)

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I had great success with Amiodarone converting a stable v-tach. Our pt was decompensating but still much too alert for non-sedated cardioversion. We set her up on a rapid drip (150mg in 50cc n/s infused over 10 minutes) and she converted about halfway through the treatment into sinus tach.... not too shabby. This was a few shifts ago and it was the first time I had ever used Amiodarone on a non-cardiac arrest pt.

Patrick

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Even with the Amiodarone being first place before Lidocaine in ACLS, I have heard that there's not such thing as the better. As said before, it's up to the patient's particular condition, sodium, potassium, and other levels. If you have all the metrics and are in the ER you can make some decisions. It is said that Lidocaine lost first place at the same time it lost the Patent (so it is very cheap) and Amiodarone (not so cheap) took the place.

I can only say that I have not any success history with any of them -few time using them, not a lot of lost patients ;-)-, but what have heard is that although there's not a clear difference some people would prefer to use Lidocaine in first place (they use Amiodarone, because of the ACLS), maybe just because they are used to.

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Even with the Amiodarone being first place before Lidocaine in ACLS, I have heard that there's not such thing as the better. As said before, it's up to the patient's particular condition, sodium, potassium, and other levels. If you have all the metrics and are in the ER you can make some decisions. It is said that Lidocaine lost first place at the same time it lost the Patent (so it is very cheap) and Amiodarone (not so cheap) took the place.

I can only say that I have not any success history with any of them -few time using them, not a lot of lost patients ;-)-, but what have heard is that although there's not a clear difference some people would prefer to use Lidocaine in first place (they use Amiodarone, because of the ACLS), maybe just because they are used to.

Greetings Heart and Soul;

Amiodarone damn it expensive stuff, but studies are looking good.

Do you use Procainamide its not a bad alternate.

Looking forward to more postings from your local amegio .....will send some snow, perheps a Beaver or a Moose?

Manyana.

ps thanks for the studies Chris :dontknow:

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I can't speak on Amiodarone, but with respect to Lidocaine, I have found it to only be regularily and quite effective in refractory VF. Everything else is a crap shoot.

Its all a crap shoot, Amnio the stuff is huge CND peso's, the Pfizer stock crashed due Vioxx and celebrex, just my luck.

Have ya got money on the BIG game? :?:

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I am not sure where you can find the study results now... maybe the prehospital research department at sunnybrook hospital might have them. But in the mid 90's toronto ems did a double blinded study with lidocaine and amiodarone with cardiac arrest patients. The results may have been scewed a bit as the amiodarone was pretty obvious to identify being that its viscosity was thicker than the placebo and it tended to foam on drawing it up. Regardless during a cardiac arrest after we opened up an envelope we used whatever the directions said lidocaine or amiodarone. I have had two viable survivers back from lidocaine, no survivors back from what I thought was amiodarone during the trial. ACLS courses in our area are suggesting that amiodarone has better antiarrhymiant qualities verses the lidocaine, and eventually we might see a switch in amiodarone going to a more effective ACLS class of antiarrhythmiant over lidocaine.

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