to test enough patients to ensure against a Type 2 error at an acceptable power. Until this is done, the statement that lidocaine does not suppress the development of malignant dysrhythmias cannot be made.
What really needs to be posed is whether this question actually needs to be answered. If the answer is affirmative, then a large, multicenter study will be required to enlist enough patients to ensure against making a Type 2 error if the null hypothesis is accepted. However, the negative may be more appropriate. Although it has not been proven statistically, there is a suggestion that lidocaine treatment may increase mortality.S, 12 Further, both in the prehospital and inpatient settings, it has been proven statistically that the prophylactic use of lidocaine in patients with suspected acute myocardial infarction does not reduce the mortality of such patients. If one accepts this, then there may be little justification for pursuing the issue further because current prehospital advanced life support providers can effectively treat emerging life-threatening dysrhythmias. Perhaps the analogy between the inpatient and prehospital setting should be extended to where, as in the inpatient environment, the routine use of prophylactic lidocaine is abandoned.