Lidocaine is a versatile medication used in various medical applications. As respiratory therapists (RTs), we occasionally administer Lidocaine breathing treatments to patients. Previously, these treatments were given before bronchoscopies to numb the patient's throat, thereby preventing the scope from irritating the cough reflex and reducing pain during the procedure. (1)
However, their necessity has been questioned by doctors in recent years, and Lidocaine breathing treatments have been used less often for this procedure—at least where I work. Nonetheless, Lidocaine nebulizers are still prescribed occasionally, primarily aimed at alleviating cough symptoms, and typically in the emergency room (ER)
Occasionally, some individuals develop a persistent cough—a condition characterized by its constant or frequent occurrence. Such a cough can become bothersome and affect a person's quality of life. It can make breathing difficult and affect one's ability to eat, converse, or even sleep. (2)
When this cough becomes bothersome enough, these patients often find it necessary to seek assistance from an emergency room physician. Among the options an ER doctor may consider is a Lidocaine breathing treatment. Here at Shoreline Medical Center, a common dosage we use is 0.4% Lidocaine in a 5 mL solution.
Similarly to its purpose before bronchoscopy, Lidocaine is used for its numbing properties. In effect, Lidocaine acts as a local anesthetic that numbs the sensory nerves in the respiratory tract. By doing so, it temporarily inhibits the cough reflex, which can be overly sensitive or hyperactive in some individuals with persistent coughs. This numbing effect helps to reduce the urge to cough, providing relief and allowing the airways to remain calm. (3)
It's been known for a long time that lidocaine acts as a topical anesthetic. When I've had bronchoscopies done in the past, they have had me squirt lidocaine laryngeal-tracheal spray into the back of my throat, and this seemed to do an effective job of numbing my airways. Various studies support that this method is effective; however, research indicates that inhaling the medicine via nebulizer route is even more effective than other administration methods (1).
References.
- Tanaffos, "Comparison of Nebulized Lidocaine and Intratracheally Injected (Spray-as-you-go) Lidocaine in Pain and Cough Reduction during Bronchoscopy," National Library of Medicine, 2022, March 21, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10073944/, accessed June 23, 2024
- Truesdale, Kelly, Adham Jurdi, "Nebulized lidocaine in the treatment of intractable cough," National Library of Medicine, American Journal of Paliative Care, 2013 https://pubmed.ncbi.nlm.nih.gov/22964341/#:~:text=Successful%20cough%20suppression%20has%20also,oropharyngeal%20numbness%2C%20and%20bitter%20taste., accessed June 23, 2024
- Beecham, Gabriel B., Trevor A. Nessel; Amandeep Goyal., "Lidocaine," National Library of Medicine, 2022, December 11, https://www.ncbi.nlm.nih.gov/books/NBK539881/, accessed June 23, 2024
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