Comparison of intravenous and topical lidocaine as a suppressant of coughing after bronchoscopy during general anesthesia

Abstract

Twenty-four consecutive patients scheduled for fiberbronchoscopy were randomized to receive double-blind either intravenous (1.5 mg/kg) or laryngotracheal (3 mg/kg) lidocaine to evaluate the influence on post-bronchoscopic laryngospasm, pain in the throat and coughing. Plasma lidocaine concentrations were analyzed 5, 15, 30 and 60 min after administration. None of the patients demonstrated laryngospasm or pain in the throat during the first hour after bronchoscopy. Patients receiving topical lidocaine coughed significantly more than patients receiving intravenous lidocaine, with a median number of coughs of 20 compared to 4, during the first hour (P less than 0.01). The plasma lidocaine concentrations were significantly higher after intravenous than after topical administration (P less than 0.001). After intravenous administration the plasma lidocaine concentrations exceeded the accepted level for potential toxicity in five out of 11 patients, but none of the patients developed toxic symptoms and no side-effects were observed.

Effects of intravenous and topical laryngeal lidocaine on heart rate, mean arterial pressure and cough response to endotracheal intubation in dogs

“…) and reduce the cough reflex (Steinhaus & Gaskin ; Jakobsen et al. ). In anaesthetized infants in whom laryngospasm was induced, IV lidocaine reduced the incidence of laryngospasm (Erb et al.…”

“…In the human literature, higher IV lidocaine doses (1.5 mg kg −1 ) are reported to be associated with beneficial effects at ETI (Jakobsen et al. ; Wilson et al. ).…”

Neuropsychiatric Side-Effects of Lidocaine: Examples from the Treatment of Headache and a Review

“…Results from the literature review on unwanted effects of i.v. lidocaine treatment in adults are presented in Table 2, including only case series (9, 10, 14–63). It includes 50 series and around 6000 patients treated for different reasons: surgical patients (for anaesthesia), pain and headache patients (for analgesia), cardiac patients (for ventricular arrhythmias), epileptic patients (for seizure control) and also healthy volunteers in experimental conditions.…”

Comparaison de l’application locale de corticoïdes et de lidocaïne dans la prévention des douleurs pharyngolaryngées post-intubation

“…Plusieurs auteurs trouvent un avantage à la lidocaïne IV dans la réduction des douleurs de gorge [11][12][13]. Ainsi, une équipe, testant la stratégie lidocaïne IV vs spray de lidocaïne intratrachéale lors d'anesthésie générale pour bronchoscopie, montre une incidence de la toux significativement plus élevée dans le groupe lidocaïne topique [14].…”