II. Indications
- Refractory, constant cough
-
Obstructive Lung Disease (e.g. Asthma, COPD) exacerbation with refractory cough
- Standard measures (Bronchodilators) are preferred
III. Precautions
- Off-label use (not recommended in most cases, except when other measures fail)
- Dosing is not standardized, and although appears safe and effective, there is a paucity of literature
-
Lidocaine can have serious toxicity (Light Headedness, Myoclonic Jerks)
- Intralipid (Lipid emulsion) is the antidote
IV. Dosing
-
General
- Use Lidocaine Solution (2% or 4%)
- Dilute in 5 cc Normal Saline
- Maximum: 1-3 mg/kg Lidocaine
- Adults
- Lidocaine 4%, 3 ml in Normal Saline nebulized up to 3-4 times daily
- Hunt (2004) J Allergy Clin Immunol 113(5):853-9. [PubMed]
- Children
- Lidocaine 2%, 0.8 mg/kg/dose to 2.5 mg/kg/dose in Normal Saline nebulized 3-4 times daily
- Decco (1999) Ann Allergy Asthma Immunol 82(1):29-32. [PubMed]