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.