Clinical Safety of Lidocaine in Patients With Cocaine-Associated Myocardial Infarction

Abstract

Study objective: To evaluate the safety of lidocaine in the setting of cocaine-induced myocardial infarction (MI). Design: A retrospective, multicenter study. Setting: Twenty-nine university, university-affiliated, or community hospitals during a 6-year period (total of 117 cumulative hospital-years). Participants: Patients with cocaine-associated MI who received lidocaine in the emergency department. Results: Of 29 patients who received lidocaine in the setting of cocaine-associated MI, no patient died; exhibited bradydysrhythmias, ventricular tachycardia, or ventricular fibrillation; or experienced seizures after administration of lidocaine (95% confidence interval, 0% to 11%). Conclusion: Despite theoretical concerns that lidocaine may enhance cocaine toxicity, the use of lidocaine in patients with cocaine-associated MI was not associated with significant cardiovascular or central nervous system toxicity. [Shih RD, Hollander JE, Burstein JL, Nelson LS, Hoffman RS, Quick AM, and the Cocaine-Associated Myocardial Infarction Study Group: Clinical safety of lidocaine in patients with cocaine-associated myocardial infarction. Ann Emerg Med December 1995;26:702-706.]