The antiarrhythmic effect of lidocaine usually starts within 1-2 minutes. The bolus is given to kick start the process. The continuous IV infusion is then maintained to make sure that lidocaine is providing a constant antiarrhythmic effect. The drug is short-lived. The effect of the drug vanes off in only 15 minutes once the IV infusion of the drug is stopped.
This means that the patient will need immediate surgical or pharmacological intervention once the lidocaine drug is stopped. Arrhythmias can be difficult to treat and often need vigilant monitoring and aggressive therapy. Especially tachycardia tends to change into ventricular fibrillation, which can be fatal.
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