Table 1 Summary of Studies on Lidocaine usage for Cough in respiratory patients
Year | Study Author(s) | Study Design/ duration | Number of participants | Disease/Condition | Stage of Disease | Lidocaine Dosage/Method | Key Findings | Outcome/Impact | Conclusion | Side effects |
|---|---|---|---|---|---|---|---|---|---|---|
1979 | J. Savoy, S. Dhingra, N. R. Anthonisen [54] | Observational, cross-sectional | 10 patients (pulmonary fibrosis), 7 controls.) | Pulmonary Fibrosis | Advanced (End-Stage) | Lignocaine airway anesthesia (tested by cough response to citric acid inhalation) | - P0.1, f1, and VT/Ti were greater in patients with pulmonary fibrosis compared to controls. | Â | Â | Â |
1996 | Hunt, Swedlund, Gleich [55] | Prospective open study | 20 (18 women, 2 men) | Severe Asthma | Severe, glucocorticoid-dependent | 40 to 160 mg nebulized, 4 times daily | 13 patients discontinued oral glucocorticoids; 4 reduced glucocorticoid dosage; 3 had no response. | 65% of patients (13 out of 20) were able to discontinue oral glucocorticoids. 20% (4 out of 20) reduced glucocorticoid dose. | Nebulized lidocaine allows reduction or elimination of oral glucocorticoid therapy. | No specific side effects mentioned. |
1996 | von Schönfeld et al. [56] | Observational study | 27 (7 with quantitative liver function tests) | Alpha-1-antitrypsin deficiency (Pi ZZ), Pulmonary Emphysema | Severe | Not specified, but lidocaine metabolism was measured (half-life) | - Liver function tests mostly normal in patients. - Mild liver enzyme elevation in 10 patients. - Lidocaine half-life was prolonged in 4 out of 7 patients. | - Lidocaine metabolism (measured by lidocaine half-life) was impaired in a subset of patients (4/7). - Liver function tests normal in the majority of patients. | No significant clinical liver disease or impairment in most patients. Lidocaine metabolism was impaired in some patients, but no statistically significant liver dysfunction in the group overall. |  |
1999 | H. Morisaki, R. Serita, Y. Innami, Y. Kotake, J. Takeda [57] | Retrospective study, single-center | 13 | Emphysema | Severe (End-stage) | Lidocaine administered for ventricular arrhythmias (method not specified) | - 13 patients with severe emphysema undergoing thoracic surgery | Â | Â | Â |
1999 | M L Decco, T A Neeno, L W Hunt, E J O'Connell, J W Yunginger, M I Sachs [58] | Open-label pilot study, duration: 7 to 16 months (mean: 11.2 months) | 6 | Severe Asthma (in children) | Severe, steroid-dependent asthma | Nebulized lidocaine 0.8 mg/kg/dose to 2.5 mg/kg/dose, 3 to 4 times daily (t.i.d to q.i.d) | Five out of six patients discontinued oral glucocorticoids after a mean of 3.4 months | 5 of 6 patients completely discontinued oral glucocorticoids (mean 3.4 months) | Lidocaine may serve as a non-toxic steroid alternative in steroid-dependent asthma | No specific side effects mentioned. |
2001 | K. Nozaki, A. Endou, K. Sakurai, O. Takahata, H. Iwasaki [59] | Case Report (Duration not specified) | 1 (76-year-old male) | Giant Bulla and Liver Cirrhosis | End-stage lung disease (giant bulla) with liver cirrhosis | Epidural analgesia with 2% lidocaine (continuous injection) | -Laryngeal mask airway (LMA) and epidural analgesia were used for anesthesia. -2% lidocaine was injected into the epidural space continuously to achieve abdominal muscle relaxation and pain management. | No neurological abnormalities or rupture of the giant bulla were observed post-surgery. | The combination of LMA and epidural lidocaine reduced the risk of giant bulla rupture during surgery and provided effective pain management. | No specific side effects mentioned. |
2001 | T. Kimura, T. Mizutani [60] | Case Report/Duration: 155 days (Postoperative period) | 1 | Unilateral Pulmonary Fibrosis, Postoperative Complications | Advanced lung disease (postoperative, progressive fibrosis) | Epidural Lidocaine (no specific dosage reported) | Rare case of unilateral pulmonary fibrosis following ipsilateral single-lung ventilation and anesthesia | The left lung developed honeycomb patterns and fibrosis, with organized pneumonia in the right lung. No autopsy performed. | Â | The patient died of respiratory failure. No clear correlation with lidocaine was found, but other mechanical factors likely contributed. Lidocaine administration (epidural) is unlikely to be the sole cause. |
2005 | C-F Chong, C-C Chen, H-P Ma, Y-C Wu, Y-C Chen, T-L Wang [11] | Prospective comparison study (Tertiary emergency department) | 127 (62 received lidocaine, 65 received bronchodilator) | Chronic Obstructive Pulmonary Disease (COPD) | Intractable cough in COPD patients | Nebulized lidocaine | Lidocaine and bronchodilator both effectively suppressed cough in COPD patients. No significant difference in efficacy between treatments. | Cough severity score significantly reduced 1 hour after treatment (both groups). No significant difference in efficacy between lidocaine and bronchodilator. | Both lidocaine and bronchodilator inhalation are equally effective for short-term cough suppression in COPD patients. | Common mild side effects: lidocaine group (oropharyngeal numbness, bitter taste); bronchodilator group (tremor, palpitation). No serious adverse events. |
2006 | Shigekazu Sugino, Keiichi Omote, Mikito Kawamata, Akiyoshi Namiki [61] | Case report | 1 | Chronic Obstructive Pulmonary Disease (COPD) | Severe COPD | 5 ml of 1.0% lidocaine injected intradermally in the right elbow for catheter sheath insertion | The patient underwent elective endovascular repair for an aortic abdominal aneurysm without intubation. Spinal anesthesia and local anesthesia were used. Lidocaine was used as part of the local anesthesia for the catheter insertion. | The procedure was completed uneventfully, and the patient did not experience postoperative respiratory failure, despite the severe COPD. | Spinal anesthesia combined with local anesthesia (including lidocaine) was deemed effective for managing this procedure in a patient with severe COPD. The patient experienced no major complications. | No specific side effects mentioned. |
2006 | Keiko Saito, Nagato Sato, Nobutaka Shimono, Kouichi Hagiwara, Minoru Kanazawa, Makoto Nagata [62] | Case report (no specific duration mentioned) | 1 | Severe Asthma | Severe, uncontrolled asthma during pregnancy | Inhalational lidocaine 40-100mg via ultrasonic nebulizer, 5 times/day | Inhalational lidocaine dramatically improved symptoms (wheezing, cough, hypoxemia) and allowed reduction of systemic corticosteroids. | Patient's asthma symptoms significantly improved, leading to the possibility of reducing systemic corticosteroid use. | Inhalational lidocaine may be a useful supplementary treatment for refractory asthma, particularly in pregnant cases. | No specific side effects mentioned. |
2007 | Pyng Lee, Henri G. Colt [63] | Case series (single procedure) | 5 patients | Pneumothorax, Severe Chronic Obstructive Pulmonary Disease (COPD) | Advanced (end-stage COPD with pneumothorax) | 250 mg Lidocaine via spray catheter before talc poudrage | Lidocaine administered via spray catheter was effective for pain control before talc poudrage in patients with pneumothoraces and severe COPD. | Pain scores were 3, 2, and 2 on postoperative days 0, 1, and 2, respectively. No complications or 30-day mortality. | Lidocaine via spray catheter provided effective pain relief. | No specific side effects mentioned. |
2009 | Miroslava Kapala, Sarkis Meterissian, Thomas Schricker [64] | Case Report | 1 | Severe COPD, Obstructive Sleep Apnea (OSA) | Severe/Advanced COPD and OSA | Intrathecal: 3.5 mL isobaric bupivacaine 0.5% with 100 µg epinephrine and 200 µg morphine; Epidural: 60 mg bupivacaine, 200 mg lidocaine | Combined spinal-epidural anesthesia with BiPAP for an elective sigmoid resection in a patient with severe COPD and OSA; perioperative BiPAP and continuous epidural infusion for pain control. | Excellent pain relief with continuous epidural infusion of local anesthetics; no adverse respiratory events. | Combined spinal-epidural anesthesia and perioperative BiPAP contributed to an uncomplicated postoperative course. | No specific side effects mentioned. |
2010 | A. Molassiotis, G. Bryan, A. Caress, C. Bailey, J. Smith [65] | Systematic Review of Trials | 1177 trials identified, 75 included | Respiratory and Non-respiratory Diseases (excluding cancer) | Chronic Cough | Lidocaine was evaluated in some studies | Positive results were seen with lidocaine among other treatments | Evidence of efficacy | Â | No specific side effects mentioned. |
2012 | K. Stuart-Smith [66] | Case Report | 1 | Severe Cardiac and Respiratory Disease (End-stage pulmonary disease) | Severe/End-stage (Cardiac and Respiratory Dysfunction) | Lidocaine 1% (20 ml) and Bupivacaine 0.5% (20 ml) for Transversus Abdominis Plane Block | The hemiarthroplasty was performed successfully with transversus abdominis plane block as the main anaesthetic technique, avoiding general or spinal anaesthesia risks in a patient with severe cardiorespiratory dysfunction. | The patient remained alert and comfortable, with no need for further analgesia during the procedure. First opioid administration occurred 12 hours post-surgery. | Surgery completed without complications. The patient succumbed to respiratory disease 6 months post-surgery. | No specific side effects mentioned. |
2014 | Naomi Ono, Nobuyasu Komasawa, Shoko Nakano, Shinichi Tatsumi, Kenta Nakao, Toshiaki Minami [67] | Case report (Duration not specified) | 1 | Emphysema with Pneumothorax due to Metastatic Lung Cancer | Advanced/End-stage (Multiple metastatic cancer, emphysema, pneumothorax) | Lidocaine via epidural anesthesia at T8-9 (in combination with dexmedetomidine) | The patient underwent successful one-lung ventilation with spontaneous breathing, using dexmedetomidine and regional anesthesia (lidocaine). No complications from the procedure. | No complications reported; stable throughout the procedure | One-lung ventilation under dexmedetomidine sedation with lidocaine as regional anesthesia effectively prevented barotrauma in this patient with metastatic lung cancer and emphysema | No specific side effects mentioned. |
2014 | Casilda Olveira, Ana Muñoz, Adolfo Domenech [68] | Review (No direct experimental data provided) | Not applicable | Various pulmonary diseases (e.g., COPD, fibrosis) | End-stage or advanced lung disease (focused on adults) | Nebulized therapy (e.g., lidocaine included in discussion) | Nebulized drugs are recommended for patients requiring high doses of bronchodilators, antibiotics, mucolytics, and other treatments, especially when other inhalation methods are not feasible. Technological advancements in devices enhance pulmonary drug deposition and reduce treatment time. | Highlights efficacy in optimized drug deposition. | Nebulized therapy has fewer systemic side effects compared to systemic administration but does not provide specific statistical data on side effects. | Implies fewer systemic side effects with nebulized therapy compared to systemic administration. |
2017 | Adrian Sultana, David Torres, Roman Schumann [69] | Review/Discussion of Various Case Reports & Prospective Studies | Not specified | Chronic Obstructive Pulmonary Disease (COPD), Obesity, Sleep Apnoea, Complex Regional Pain Syndromes, Opioid Addiction, Cancer Surgery | Advanced stages in some cases, depending on the disease | Intravenous lignocaine (Lidocaine) used in opioid-free anaesthesia techniques | Lignocaine used for sympatholysis (reduction of sympathetic nervous system activity) and co-analgesia | The review found benefits in using opioid-free techniques, including improved outcomes for patients with COPD and obesity. Specifically, lignocaine helped reduce the need for opioids and improved perioperative analgesia. | No specific statistical results provided in the abstract, but the benefits of opioid-free anaesthesia were noted for reducing opioid-related complications | Side effects or adverse reactions to lignocaine or opioid-free anaesthesia were not discussed in detail. However, general concerns about the avoidance of opioids (e.g., in COPD patients) may be a consideration for managing respiratory function. |
2023 | Yongbin Wang, Chang Feng, Jia Fu, Dongyi Liu [70] | Randomized Controlled Trial (RCT), Duration not specified | 60 patients | Chronic Obstructive Pulmonary Disease (COPD) | Severe COPD | 2 mL of 2% lidocaine for bilateral internal branch of the superior laryngeal nerve block | - Shortened intubation time in lidocaine group. - Significantly fewer adverse reactions in lidocaine group. - Higher comfort score in lidocaine group. - Better haemodynamic stability and reduced stress response (lower MAP, HR, NE, and AD in lidocaine group) . | - Significant reduction in intubation time (P<0.01). - Significantly fewer adverse events and better comfort score (P<0.01). - Haemodynamic stability and stress markers significantly lower in lidocaine group (P<0.05). | Ultrasound-guided internal branch of superior laryngeal nerve block using lidocaine reduces intubation time, adverse reactions, and improves comfort in severe COPD patients undergoing awake fibreoptic nasotracheal intubation. | No specific side effects mentioned. |
1973 | Frank Rodriguez-Martinez, Armand V Mascia, Robert B Mellins [71] | Experimental, cross-sectional study | 8 children with chronic asthma and 9 controls | Asthma | Chronic asthma | Topical lidocaine spray applied to the nose and pharynx | - Cold-induced increase in airway resistance in untreated asthmatic children | - Significant decrease in FEV1, MVV, V50, and V25 at low temperature in untreated asthmatic children (P < 0.01) - No significant change in test results after lidocaine treatment (P > 0.05) | Cold-sensitive receptors are present in the upper airways, and cold-induced bronchoconstriction is reflexive | No specific side effects mentioned. |
1977 | Earle B. Weiss, M.D., F.C.C.P. & Avinash V. Patwardhan, M.D. [72] | Observational study | 22 patients | Bronchial Asthma | Stable asthma | Aerosol: 40 mg and 100 mg doses; Intravenous: 1 mg/kg body weight | Initial response: ~20% fall in expiratory airflow rates within 5 minutes of aerosol administration. Bimodal response: Group 1 showed continued reduction in airflow; Group 2 showed improvement in airway resistance. | Aerosol 100 mg dose: Group 1 saw maximal decrease in FVC (−24.6%), FEV1.0 (−38.0%), MMEFR (−42.6%). Group 2 saw significant improvement in FVC (+11.8%), FEV1.0 (+25.2%), MMEFR (+41.0%). Intravenous lidocaine: Mild bronchodilator effect. | Aerosol lidocaine produced a variable response: a significant fall in airway flow for some and improvement in others. Intravenous lidocaine was only mildly effective as a bronchodilator. | No specific side effects mentioned, brief initial bronchoconstriction was noted. |
1979 | J E Fish, V I Peterman [73] | Experimental, cross-sectional study (duration not specified) | 8 asthmatic subjects | Asthma | Not specified (general asthma subjects) | Inhaled 2 cm³ of lidocaine (4%) | - Significant fall in FEV1 (23.4 ± 4.8%) and SGaw (64.1 ± 3.8%) after inhalation of lidocaine (p < 0.001) - Bronchoconstrictor effects were reversed with aerosolized atropine or isoproterenol. | FEV1: -23.4 ± 4.8%, SGaw: -64.1 ± 3.8% (statistically significant, p < 0.001). | Inhaled lidocaine causes bronchoconstriction in asthmatic subjects, which can be prevented or reduced by bronchodilators (aerosolized atropine or isoproterenol). | Reflex-mediated bronchoconstriction. |
1980 | P.L. Enright, J.F. McNally, J.F. Souhrada [74] | Experimental (with treadmill exercise testing) | Not specified | Bronchial Asthma | Not specified | 4% Lidocaine aerosol, delivered during the last third of inspiration | Lidocaine blocked exercise-induced bronchoconstriction (EIB), as measured by multiple pulmonary parameters (FEV1, FEF25-75%, Vmax70% TLC, SGaw). Decreased minute ventilation (VE) during exercise. | EIB was significantly inhibited, and VE during exercise decreased (p < 0.01). | Local anesthesia of the upper and large airways significantly inhibits EIB and decreases VE during moderate exercise. | No specific side effects mentioned, but brief absence of cough and gag reflexes for 15-20 minutes after treatment. |
1980 | C H Fanta, R H Ingram Jr, E R McFadden Jr [75] | Experimental (Eucapnic hyperventilation challenge) | 10 | Exercise-induced asthma (EIA) | N/A | Oropharyngeal spray of lidocaine vs. water | - No change in pulmonary mechanics at rest after lidocaine or water spray. - Both lidocaine and water followed by significant reduction in pulmonary function after hyperventilation. - No difference between lidocaine and water. | Significant reduction in pulmonary mechanics observed after eucapnic hyperventilation in both conditions (lidocaine and water) | The study did not find evidence for "irritant-like" receptors in the posterior pharynx affecting airway cooling during exercise-induced asthma. | No specific side effects mentioned. |
1982 | W M Tullett, K R Patel, K E Berkin, J W Kerr [76] | Single-blind trial (duration not specified) | 8 | Exercise-induced asthma | Not specified | Inhaled lignocaine (48 mg) | No significant change in baseline FEV1 or MMFR after lignocaine. Ipratropium bromide caused bronchodilation, sodium cromoglycate had inhibitory effects, lignocaine had no significant effect. | Maximal percentage fall in FEV1 after exercise: saline (38.1%), lignocaine (34.5%), sodium cromoglycate (11.3%), ipratropium bromide (19.3%). Maximal fall in MMFR: saline (54.4%), lignocaine (52.9%), sodium cromoglycate (23.6%), ipratropium bromide (32.1%). | Sodium cromoglycate and ipratropium bromide had significant protective effects, while lignocaine did not. Local anaesthesia of sensory vagal receptors is not effective in preventing exercise-induced asthma. | No specific side effects mentioned. |
1982 | D Murciano, M Aubier, F Viau, S Bussi, J Milic-Emili, R Pariente, J P Derenne [77] | Observational study; no specified duration | 14 | Chronic Obstructive Pulmonary Disease (COPD) | Acute respiratory failure | Airway anesthesia by fiberoptic xylocaine from the larynx to subsegmental bronchi | 1. Decrease in minute ventilation by 6 ± 1%.2. Respiratory frequency decreased by 14.5 ± 1%.3. Increased expiratory time.4. Increased tidal volume by 10.1 ± 0.6%.5. Arterial blood gas deterioration. | PaO2: 42 ± 3 mmHg (post-anesthesia) vs 48 ± 2 mmHg (control).PaCO2: 62 ± 3 mmHg (post-anesthesia) vs 54 ± 2 mmHg (control). | Activation of airway receptors contributes to rapid and shallow breathing in COPD patients during acute respiratory failure.Airway xylocaine anesthesia worsens blood gases and is contraindicated in these patients. | Worsened arterial blood gases: decrease in PaO2 and increase in PaCO2. |
1983 | H Downes, C A Hirshman, D A Leon [78] | Comparative study, experimental in dogs (Basenji-Greyhound), duration of aerosol administration: 10 minutes before citric acid challenge | Basenji-Greyhound dogs (specific number not mentioned in abstract) | Airway constriction (provoked by citric acid aerosols) | Airway constriction induced by citric acid challenge (not specified as a disease but more of an experimental provocation) | 4% Lidocaine aerosol for 10 minutes immediately preceding citric acid challenge | - Lidocaine aerosols (4%) did not prevent citric acid-induced increases in pulmonary resistance or changes in dynamic compliance.- Other anesthetics (bupivacaine, hexylcaine, procaine) showed similar results. | - Pulmonary resistance increased by 3.3 +/- 0.8 cmH2O X 1(-1) X s in controls.- Lidocaine: 2.1 +/- 0.6 cmH2O X 1(-1) X s.- Bupivacaine: 3.2 +/- 1.3 cmH2O X 1(-1) X s.- Procaine: 3.3 +/- 1.0 cmH2O X 1(-1) X s.- Hexylcaine: 2.1 +/- 0.6 cmH2O X 1(-1) X s. | Local anesthetic aerosols, including lidocaine, were ineffective in preventing airway constriction provoked by non-reflex stimuli. | No specific side effects mentioned. |
1984 | W Hida, M Arai, C Shindoh, Y N Liu, H Sasaki, T Takishima [79] | Observational study on inspiratory flow rate and bronchomotor tone, no duration specified in the abstract | 31 (9 normal subjects, 22 asthmatic subjects) | Asthma, Bronchoconstriction (methacholine-induced) | Asthmatic subjects with spontaneous airway narrowing; methacholine-induced bronchoconstriction | Lignocaine (Lidocaine) inhalation | - In normal subjects with methacholine-induced bronchoconstriction, rapid deep inspiration reduced resistance more than slow inspiration. - Asthmatic subjects showed increased resistance after deep inspiration, greater after rapid inspiration. - Methacholine-induced bronchoconstriction showed greater bronchodilatation with rapid deep inspiration. - Lignocaine inhalation attenuated both bronchoconstriction and bronchodilatation. | Not specified numerically in the abstract; however, Lignocaine reduced bronchomotor tone significantly with both rapid and slow inspirations. | - Deep inspiration affects bronchomotor tone, and its effects differ between normal and asthmatic subjects. - Lignocaine inhalation attenuates bronchoconstriction and bronchodilatation, suggesting a role of irritant and stretch receptors in bronchomotor tone regulation. | No specific side effects mentioned. |
1986 | A Van Meerhaeghe, M Bracamonte, R Willeput, R Sergysels [80] | Experimental study (unspecified duration) | 16 (8 normal, 8 COPD patients) | Chronic obstructive pulmonary disease (COPD) | Eucapnic (stable) COPD, Normal | 4% lidocaine aerosol (240 mg) delivered to upper and large airways | 1. Lidocaine eliminated gag and cough reflexes in all subjects. 2. No significant changes in pulmonary function at baseline or during exercise. 3. No effect on O2 intake (VO2) or blood gases during exercise | No significant changes in respiratory variables during exercise, before or after lidocaine (p > 0.05) | Vagal upper and large airway receptors do not play a significant role in breathing pattern or ventilatory drive during exercise in either normal subjects or COPD patients. | No specific side effects mentioned. |
1987 | W.Y. Chen, H. Chai [81] | Experimental; 2 sessions of 10 min treadmill exercise | 5 | Exercise-induced asthma | Not specified | Inhaled aerosol lidocaine (1.5 mg/kg) | - Pulmonary function tests measured before, after lidocaine inhalation, and post-exercise.- Decreased FEV1 and FEF25-75% post-exercise in both control and lidocaine sessions. | - Control session: FEV1 61% and FEF25-75% 44% of baseline.- Lidocaine treatment: FEV1 54% and FEF25-75% 44% of baseline.- No significant difference between control and lidocaine. | Afferent nerves in the respiratory mucosa do not play a critical role in exercise-induced asthma development. | No specific side effects mentioned. |
1989 | M Söderberg, R Lundgren [82] | Experimental study; no duration mentioned | 21 healthy non-smoking volunteers, 6 asthmatics (for additional tests) | Healthy volunteers, Asthma | Healthy, Asthmatic | Topical anesthesia with lignocaine | FFB did not alter airway responsiveness; atropine and lignocaine had no major influence on airway responsiveness | No statistical changes in airway responsiveness before or after FFB in both groups | Epithelial damage in the central airways induced by FFB is not sufficient to induce bronchial hyperresponsiveness | No specific side effects mentioned. |
1989 | L.G. McAlpine, N.C. Thomson [83] | Observational, cross-sectional (single-day study) | 20 | Asthma | Moderate/Stable | 6 ml 4% topical lidocaine (Xylocaine 4%) inhaled | - No correlation between histamine airway responsiveness and lidocaine-induced bronchoconstriction. - 25% of patients showed >15% fall in FEV1, with a maximum of 42.1%. - No difference in response to lidocaine with or without preservative. | 25% of asthmatic patients experienced significant bronchoconstriction (>15% fall in FEV1).Maximum fall was 42.1%. | Inhaled topical lidocaine can induce significant bronchoconstriction in asthmatic patients.The response is not related to histamine airway responsiveness or preservative content. | Bronchoconstriction (up to 42.1% fall in FEV1) in 25% of patients. |
1989 | N Caire, A Cartier, H Ghezzo, J L'Archevêque, J L Malo [84] | Randomized, single-blind, cross-over study with 4 visits (2 placebo, 2 active), max interval of 3 weeks | 8 | Asthma | Clinical steady state | 40 mg inhaled lignocaine solution | No significant changes in FEV1 and PD20 after inhalation of lignocaine vs placebo | No significant changes in forced expiratory volume (FEV1) or PD20 after lignocaine inhalation (p > 0.05) | Inhaled lignocaine does not significantly alter bronchial hyperresponsiveness to cold dry air in asthmatic subjects | No specific side effects mentioned. |
1990 | G S Prakash, S K Sharma, J N Pande [85] | Single-blind study, Duration not specified | 18 | Chronic stable asthma | Stable asthma | 4% Lidocaine inhalation | - V50 at 15 min significantly decreased (p < 0.05).- 8 out of 15 patients showed decreased airway resistance (Raw).- 7 out of 15 patients showed increased specific airway conductance (SGaw).- No significant change in pulmonary function after 30 min. | - V50 decrease in 8/18 patients.- V25 decrease in 6/15 patients.- FEF25-75 decrease in 5/15 patients after 15 min.- No significant effect after 30 min. | Lidocaine produces a small bronchodilatory effect on large airways and a bronchoconstrictor effect on small airways after 15 min of inhalation. The effect is not statistically significant but is safe for use in bronchoscopy for patients with asthma. | No specific side effects mentioned. |
1991 | S Nakai, Y Iikura, K Akimoto, K Shiraki [86] | Experimental (Intradermal and bronchial challenge tests) | Not specified | Bronchial Asthma, Allergic Disorders | Moderate to Severe Asthma | Lidocaine (concomitant use) | Substance P induced stronger cutaneous and bronchial reactions in children with moderate or severe asthma compared to controls. Lidocaine inhibited these reactions, including intradermal erythema, wheal reactions, and bronchial airflow limitations. | Significant inhibition of substance P-induced erythema, wheal reactions, and airflow limitations. Lidocaine showed effectiveness in histamine-induced erythema and house dust-induced wheal and erythema reactions. | Substance P plays a role in cutaneous and bronchial hypersensitivity in children with asthma. Lidocaine can inhibit substance P-induced reactions effectively. | No specific side effects mentioned. |
1993 | H K Makker, S T Holgate [87] | Clinical Trial, Duration not specified | 11 | Asthma | Not specified | Inhaled lidocaine | Hypertonic saline challenge induced bronchoconstriction in asthma. Atropine, ipratropium, and lidocaine increased PD20HS. | PD20HS increased 2.6 times with lidocaine. No significant effect on baseline FEV1. | Anticholinergic and local anesthetic drugs, including lidocaine, suggest neurogenic reflexes contribute to hypertonic saline-induced bronchoconstriction in asthma. | No specific side effects mentioned. |
1997 | A. A. Floreani, S. I. Rennard [88] | Experimental/Review (no clear duration) | Not specified | Asthma | Not specified | Inhaled or systemic | Lidocaine may play a role in asthma therapy through inhibition of neurogenic inflammation and possibly mast cell function. | No specific statistics provided in the abstract. | Lidocaine could be beneficial in treating asthma, particularly in reducing neurogenic inflammation and mast cell activity. | No specific side effects mentioned. |
1998 | T. W. Harrison, A. E. Tattersfield [89] | Randomized, double-blind, placebo-controlled study | 20 | Asthma | Mild to moderate asthma | Inhaled lignocaine 40 mg and 160 mg (single doses), saline placebo | Lignocaine caused an initial fall in FEV1 for all doses compared to placebo; no significant difference between treatments. | FEV1 change: 0.13, 0.19, and 0.231 for saline, 40 mg and 160 mg, respectively (P = 0.2). No significant effect on heart rate, blood pressure, or bronchial reactivity to methacholine. | Single doses of inhaled lignocaine are well tolerated in mild to moderate asthma; bronchoconstriction prevented with salbutamol pretreatment. | No specific side effects mentioned, no effect on heart rate, blood pressure, or bronchial reactivity. |
2000 | H. Groeben [90] | Observational study (exact duration not specified) | Not specified | Bronchial hyperreactivity | Not specified | Intravenous lidocaine: 1.5-2.0 mg/kg | High thoracic epidural anesthesia causes a slight decrease in vital capacity but does not increase airway resistance or bronchial reactivity. Local anesthetics decrease bronchial reactivity, mainly due to systemic lidocaine. | Intravenous lidocaine (1.5-2.0 mg/kg) shows an effect similar to salbutamol. An additive effect occurs when combined with salbutamol. | High thoracic epidural anesthesia can be safely used in patients with bronchial hyperreactivity. Intravenous lidocaine can be used prophylactically before airway instrumentation. | No specific side effects mentioned.Possible concerns about motor blockade and pulmonary sympathicolysis. |
2000 | A D Maslow, M M Regan, E Israel, A Darvish, M Mehrez, R Boughton, S H Loring [91] | Prospective, randomized, double-blind, placebo-controlled trial | 110 total (60 for lidocaine vs placebo group, 50 for albuterol vs placebo group) | Asthma | Not specified (general asthma, likely stable or mild to moderate cases) | 1.5 mg/kg intravenous lidocaine administered 3 minutes before tracheal intubation | - Lidocaine did not reduce airway reactivity post-intubation. - Albuterol significantly reduced airway resistance (RL) post-intubation. | - No significant difference in peak RL between lidocaine and placebo groups (8.2 vs 7.6 cm H2O.l-1.s-1). - Albuterol group had significantly lower peak RL (5.3 vs 8.9 cm H2O.l-1.s-1, P < 0.05). - Albuterol group had lower frequency of bronchoconstriction (1 of 25 vs 8 of 23, P < 0.05). | Inhaled albuterol blunted airway response to tracheal intubation in asthmatic patients, whereas intravenous lidocaine did not. | No specific side effects mentioned. |
2000 | E.L. Langmack, R.J. Martin, J. Pak, M. Kraft [92] | Prospective, observational study | 51 | Asthma (mild to moderate) | Mild to moderate asthma | 600 ± 122 mg (8.2 ± 2.0 mg/kg) administered topically to the upper airway and tracheobronchial tree for bronchoscopy | No signs or symptoms of lidocaine toxicity. Serum lidocaine concentrations (SLC) ranged from 0.10-2.90 mg/L at time 1 and 0.50-3.20 mg/L at time 2. | No significant relationship between SLC and age, sex, weight, baseline FEV1, procedure length, or study protocol. Significant correlation with lidocaine dose: time 1 (r = 0.33, p = 0.021); time 2 (r = 0.33, p = 0.023). | 600 mg (8.2 mg/kg) of lidocaine appears to be safe for mild to moderate asthmatics undergoing research bronchoscopy. | No specific side effects mentioned. |
2000 | H Groeben, T Grosswendt, M Silvanus, M Beste, J Peters [90] | Experimental study | 15 mild asthmatic patients | Asthma | Mild asthma (responsive to histamine challenge) | Inhalation of lidocaine at 1%, 4%, and 10% concentrations, total doses of 0.5, 2.0, and 5.0 mg/kg | Lidocaine inhalation attenuates bronchial hyper-reactivity but causes airway irritation. Increasing concentration increases initial bronchoconstriction. | FEV1 decreased most at the highest dose (from 3.79 ± 0.15 to 3.60 ± 0.15, P = 0.0012). PC20 significantly increased after lidocaine inhalation (baseline: 6.1 ± 1.3 mg/mL to 18.3 ± 4.5 mg/mL with 10% dose). No significant difference in anaesthesia duration between 4% and 10% solutions. | The most effective dose for local anaesthesia and attenuation of bronchial hyper-reactivity with the least airway irritation is 2.0 mg/kg as a 4% solution. | Plasma concentrations were below toxic thresholds. Bronchoconstriction at higher doses. Airway irritation present but manageable. |
2000 | Maslow AD, Regan MM, Israel E, et al. [91] | Prospective randomized controlled trial | 60 | Asthma (status asthmaticus) | Acute status asthmaticus | 1.5 mg/kg lidocaine or saline given 3 minutes before intubation | No significant difference in pulmonary resistance (8.2 vs 7.6 cm water, ns). Frequency of airway response (6/30 vs 5/27, ns) | No significant difference in airway response or pulmonary resistance | No evidence to support use of intravenous lignocaine as a pretreatment for intubation-induced bronchoconstriction in asthmatic patients | No specific side effects mentioned. |
2004 | Hunt LW, Frigas E, Butterfield JH, Kita H, Blomgren J, Dunnette SL, Offord KP, Gleich GJ [93] | Randomized, placebo-controlled study, 8 weeks | 50 (25 lidocaine, 25 placebo) | Asthma (mild-to-moderate) | Mild-to-moderate asthma | Nebulized lidocaine 4%, 100 mg, 4 times daily | Improved FEV1, decreased nighttime awakenings, reduced bronchodilator use, lower blood eosinophil counts in the lidocaine group | FEV1 (P ≤ 0.001), Nighttime awakenings (P ≤ 0.02), Symptoms (P ≤ 0.01), Bronchodilator use (P ≤ 0.01), Blood eosinophils (P ≤ 0.02); placebo group showed worsened symptoms and increased eosinophils | Nebulized lidocaine was effective and safe in improving asthma symptoms and reducing glucocorticoid use in mild-to-moderate asthma | No specific side effects mentioned. |
2007 | Herng-Yu Sucie Chang, Alkis Togias, Robert H. Brown [94] | Observational Study (No Duration Mentioned) | 15 | Asthma | Not specified | IV Lidocaine infusion | -Significant decrease in FEV1 (7 +/- 2%, P = 0.006). - Small decrease in airway luminal diameter (-3 +/- 0.5%, P < 0.001). 3. Significant correlation between change in FEV1 and airway luminal diameter (r2 = 0.47, P = 0.01). | -Decrease in FEV1 (7%)- Significant narrowing of airway diameter (-3%) | Lidocaine increases airway tone and narrows the airways during infusion in asthmatic subjects. It does not reduce baseline airway tone. | No specific side effects mentioned.but the study suggests the need for monitoring airways due to potential airway narrowing during lidocaine infusion. |
2007 | Michael Adamzik, Harald Groeben, Ramin Farahani, Nils Lehmann, Juergen Peters [95] | Controlled Clinical Trial, Duration not specified | 30 | Asthma | Not specified | 2 mg/kg IV for 5 min, followed by 3 mg/kg/h for 10 min | Lidocaine mitigates bronchoconstriction after intubation in patients with asthma. | Airway resistance decreased by 26% after lidocaine administration (p < 0.004), compared to a 38% increase with saline. | IV lidocaine mitigates bronchoconstriction in asthma patients post-intubation. | No specific side effects mentioned. |
2008 | Burches, Bobby R. Jr BS; Warner, David O. MD [96] | Case Report, October 2008 | 1 (17-month-old female) | Asthma (Mild Intermittent Asthma) | Mild Intermittent Asthma | IV lidocaine, 1.5 mg/kg (13 mg total) | Bronchospasm developed after IV lidocaine injection during anesthesia induction | Bronchospasm resolved in approximately 5 minutes without further interventions. | IV lidocaine may cause bronchospasm in pediatric patients with asthma, but it was transient and self-limited. | Bronchospasm, transient and self-limited, with no evidence of anaphylaxis or aspiration. |
2008 | Chih-Chuan Lin, Kuan Fu Chen, Chia-Pang Shih, Chen-June Seak, Kuang-Hung Hsu [97] | Observational, retrospective cohort study | 149 (28 hypotension group, 121 control group) | Chronic obstructive pulmonary disease (COPD), Sepsis, Other underlying diseases | Not specified (patients with underlying diseases) | Lidocaine (specific dosage/method not mentioned) | Lidocaine, low body weight, preintubation BP <140 mm Hg, and underlying conditions (e.g., COPD, sepsis) were significant factors associated with hypotension after RSI. | The presence of COPD and sepsis, low body weight, and lower preintubation BP were significant predictors of postintubation hypotension. | Clinical practitioners in the ED should take a patient's predisposing factors into serious consideration before emergency intubation while a preplanned strategy is made | Lidocaine usage was associated with postintubation hypotension. |
2010 | Tammy Abuan, Melissa Yeager, A. Bruce Montgomery [98] | Two double-blind, randomized, placebo-controlled clinical studies. Study 1: 12 weeks; Study 2: 20 weeks | Study 1-Mild/Moderate: 154 patients. Study 2-OCS: 114 patients | Asthma | Study 1-Mild/Moderate: Mild to moderate asthma. Study 2-OCS: More severe asthma with chronic oral corticosteroid (OCS) treatment. | Lidocaine solution for inhalation (LSI); 40 mg twice daily via eFlow nebulizer | - No improvement in pulmonary function (FEV1) in Study 1-Mild/Moderate after 12 weeks. - No corticosteroid-sparing effect in Study 2-OCS after 20 weeks. | No significant improvements in asthma symptom scores, peak expiratory flow values, FEV1 % predicted, asthma instability, or quality-of-life scores. | Inhaled lidocaine did not improve pulmonary function or reduce corticosteroid use in asthma treatment. It is not a useful treatment for asthma. | LSI was well tolerated. No specific side effects mentioned. |
2013 | Laura A Nafe, Vamsi P Guntur, John R Dodam, Tekla M Lee-Fowler, Leah A Cohn, Carol R Reinero [99] | Controlled Clinical Trial (2 weeks of treatment, 2-week washout) | 14 cats (5 healthy, 9 asthmatic) | Feline Asthma | Experimental Asthma | Nebulized lidocaine (2 mg/kg q8h for 2 weeks) | Lidocaine did not alter BALF eosinophilia in healthy cats; in asthmatic cats, it increased EC200Raw (airway resistance) | EC200Raw increased significantly in asthmatic cats (10 ± 2 vs 5 ± 1 mg/ml, P = 0.043) | Lidocaine did not induce airway inflammation or hyper-responsiveness in healthy cats, but increased airway resistance in asthmatic cats | No specific side effects mentioned. |
2018 | F Tatulli, A Delcuratolo, A Caraglia, A Notarnicola, F P N Carbone, A Caputi [100] | Case report (duration: 90 minutes surgery) | 1 | Asthma | Partly-controlled asthma | Irrigation of the right subdiaphragmatic surface with lidocaine to control right shoulder pain | Three-trocar laparoscopic cholecystectomy under spinal anesthesia with low-pressure pneumoperitoneum (8 mmHg) | Successful surgery, no post-operative complications, discharge after 2 days | Spinal anesthesia and low-pressure pneumoperitoneum are safe and effective for patients with asthma in laparoscopic surgery | No specific side effects mentioned. |
2022 | Ananya Mahalingam-Dhingra, Melissa R. Mazan, Daniela Bedenice, Michelle Ceresia, Jill Minuto, Edward F. Deveney [101] | CONSORT-guided, randomized, double-blind, controlled pilot clinical trial, 14 days | 19 recruited, 13 completed | Equine Asthma | Chronic/Active Asthma | Nebulized 1.0 mg/kg body weight q12h for 14 days | Lidocaine and budesonide cohorts both showed significant decreases in clinical scores. Lidocaine cohort showed significant reductions in BAL neutrophil percentage and tracheal mucus score. No significant changes in lung function. | Both groups showed significant clinical improvements (P < 0.05). Lidocaine significantly reduced BAL neutrophil percentage and tracheal mucus score. No changes in lung function parameters. No adverse events occurred. | Lidocaine may be a safe and effective treatment for equine asthma, particularly in horses intolerant to corticosteroids. | No specific side effects mentioned. |