Nebulized Lidocaine

Patients were studied on three consecutive days and were given nebulized saline on day 1, lignocaine 100 mg on day 2, and then lignocaine 200 mg on day 3. Lignocaine is the same as lidocaine hydrochloride (name used in the United States).

• The sample was comprised of six patients with cancer (four with lung cancer and two with breast cancer); all patients were breathless at rest but had stable symptoms for two weeks. Four patients had coexisting lung disease.
• Age ranged from 66 to 76 years.
• Oxygen saturation ranged from 78% to 98%.

Vital signs were measured and pulse oximetry was performed at baseline and 10, 20, and 30 minutes following treatment. Forced expiratory volume in the first second (FEV1) was measured before and 30 minutes after treatment. A visual analog scale (VAS) measured work of breathing and distress of breathing at baseline and 10, 20, 30, and 60 minutes following the intervention.

No significant differences in vital signs or FEV1 existed between treatments. Two patients developed a wheeze after the 200-mg dose of lignocaine, but no bronchodilator was required. The rate of breathing effort decreased after all three treatments, with no significant differences between treatments. The distress of breathing decreased after saline and increased slightly but was statistically significantly (p < 0.025) with both doses of lignocaine. No benefit was seen with inhaled lignocaine.

• The study had a small sample size (N = 6).
• The authors stated that the sample was limited because most patients were either too unhealthy or insufficiently stable to participate in the study.