Chest
BronchoscopyCombined Lidocaine and Salbutamol Inhalation for Airway Anesthesia Markedly Protects Against Reflex Bronchoconstriction
Section snippets
Subjects
After approval of the local ethics committee and receiving informed written consent from the patients, 15 subjects ([mean ± SD] age 34.9 ± 6.4 years) were enrolled in this randomized, double-blinded, placebo-controlled study, which is the third part of an extended work consisting of three study arms. The results of the first study arm (IV lidocaine vs salbutamol) and the second study arm (lidocaine inhalation vs IV lidocaine) have already been published.514 The subjects were of normal height
Results
Lidocaine inhalation decreased FEV1 and VC significantly, while both salbutamol and combined salbutamol and lidocaine inhalation improved lung function.
The inhalation of saline solution (placebo) did not alter either FEV1 (3.78 ± 0.92 L; p = 0.6701) or VC (4.88 ± 1.31 L; p = 0.1118). Lidocaine inhalation significantly decreased FEV1 by 7.1% from 3.82 ± 0.90 to 3.54 ± 0.86 L (p = 0.0054), but not VC (4.84 ± 1.12 to 4.70 ± 1.07 L [2.9%]; p = 0.3109). Salbutamol inhalation significantly improved
Discussion
Lidocaine inhalation significantly attenuated bronchial hyperreactivity as much as the inhalation of salbutamol in awake humans. Salbutamol and lidocaine combined attenuated bronchial hyperreactivity even further. Furthermore, lidocaine inhalation evoked a significant initial decrease of FEV1, which was completely prevented by salbutamol pretreatment. Salbutamol pretreatment had no influence on lidocaine absorption and the resulting plasma concentrations.
These results emerged in 15 volunteers
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2020, Medical HypothesesCitation Excerpt :Some studies have showed that extensive use of 10% lidocaine infusion may cause reflex bronchoconstriction in asthmatics [38–39], other studies found no effect on the airways [36,40] and it appears that route of administration may be important in this adverse outcome (nebulized being safer). If patients suffer from asthma or hyperreactive airway, it may be reasonable to pre-administer a bronchodilator which usually prevents the potential of a bronchospasm induced by lidocaine [39]. Lidocaine inhalation has anti-inflammatory effects that are predicted to reduce inflammatory cytokines which appear to be a major problem in COVID-19-related cytokine storm [41].
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Presented in part at the Annual Meeting of the American Thoracic Society, Chicago, IL, April 24 to 29, 1998.