Bronchospasm lidocaine

Chlorine. Lacrimation. Rhinorrhea. Conjunctival irritation. Cough. Sore throat. Hoarseness Laryngeal edema. Dyspnea. Stridor. ARDS. Pulmonary edema Decontamination Copious water irrigation of the skin, eyes, and mucosal membranes to prevent continued irritation and injury Symptomatic care (no antidote) Warm/moist air, supplemental oxygen, positive pressure O2 for pulmonary edema Bronchospasm Beta-agonists (albuterol) Severe bronchospasm Corticosteroids (prednisone) (also used for PTS with H/0 asthma but use unproven) Analgesia and cough Nebulized lidocaine (4% topical solution) or nebulized sodium bicarbonate (use unproven)... 

Ketamine relaxes smooth muscles in the airways and may therefore be a useful induction agent in children with asthma (6). If endotracheal intubation is required, lidocaine 1-2 mg/kg intravenously before intubation has been recommended, although the use of a laryngeal mask airway may be more appropriate. When used in combination with midazolam by infusion, ketamine provides analgesia and prevents and relieves bronchospasm (7). 

Life-threatening bronchospasm can occur after either spinal or topical use of lidocaine. In one series of patients being treated with lidocaine spray 40 mg for persistent cough, there was an increase of airway resistance (SED-12, 255) (22). 

Unilateral bronchospasm has been described in a 19-year-old woman after the administration of lidocaine 4% 5 ml into the larynx via a Laryngojet injector (352). 

Farmery AD. Severe unilateral bronchospasm mimicking inadvertent endobronchial intubation a complication of the use of a topical lidocaine Laryngojet injector. Br J Anaesth 2000 85(6) 917-19. 

A Sotalol has nonselective beta-blocking properties that may cause bronchospasm in patients with asthma and COPD. Although amiodarone has beta-blocking activity, this effect is specific to the heart and therefore is not contraindicated in patients with asthma. Also, the patient has not taken amiodarone for a long enough period to develop pulmonary fibrosis. Procainamide, quinidine, and lidocaine are unlikely to cause bronchospasm. 

Penbutolol has been shown to increase the volume of distribution of lidocaine in normal patients, implying that it may increase the loading dose requirements in some patients. Clinical signs of overdose may include bradycardia, bronchospasm, heart failure, and severe hypotension. 

Respiratory Topical lidocaine can cause bronchospasm and airways obstruction in asthmatics [73 ] as can intravenous lidocaine [74- ]. 

A 17-month-old child was given intravenous lidocaine 1.5 mg/kg to facilitate endotracheal intubation and immediately developed bronchospasm, which resolved uneventfully after 5 minutes. 

---