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Nebulized Lidocaine in Covid-19
Nebulized Lidocaine in Covid-19
Introduction
* Coronavirus disease-2019 is a disease that affect respiratory tract.
* World Health Organization states it as a pandemic.
* zoonotic disease.
* Symptoms
* no available vaccine
* POINTS *
* body try to fight the virus by immune responses but (ARDS) and (SARS) and (MERS) cause abnormal activation of the immunity system and severe inflammatory response leading to cytokine storm.
Role of inflammatory response in respiratory distress
* The virus entry to the cells
* Lymphocytopenia -> cell hypersensitivity
* Treatment: anti inflammatory agents such as Lidocaine
* POINTS *
conclusion
& discussion
Possible Lidocaine effects on Covid-19
conclusion
discussion
Dosage and Safety of nebulized Lidocaine
1. Dose of nebulized lidocaine
Since neublized lidocaine cause airway constriction so we should make combination between lidocaine & salbutamol (long acting beta agonist) in order to decrease the bronchoconstriction without interfere with cardiac activity. This combination produce bronchial anesthesia without affect blood oxygenation.
* Nebulized Lidocaine solutions should be in range of 1% to 4% without making any side
effects.
* 4% of lidocaine put in nebulized form should be given between 320 and
480 mg of a daily dose every 4–6 hours.
* Some studies showed that lidocaine
inhalation has no side effects on large doses up to 575 mg due to it short half life.
2. The risk of bronchoconstriction is still controversial
* Increasing initial dose 1% till 4% of Nebulized Lidocaine
in 2 ml of saline can reduce lidocaine effect that is bronchospasm
* Typical toxic dose in 9 to 10
mcg/ml will cause muscular fasciculation\tremors\Agitation\convulsions\lidocaine induced
bronchospasm.
* Lidocaine had been safely administered to COVID-19 patients to manage cough
during intubation and extubation, and to prevent the cardiac complications resulted from
chroroquine, hydroxychloroquine, or azithromycin
experiment
& results
Dosage and Safety of nebulized Lidocaine
1. Dose of nebulized lidocaine
Since neublized lidocaine cause airway constriction so we should make combination between lidocaine & salbutamol (long acting beta agonist) in order to decrease the bronchoconstriction without interfere with cardiac activity. This combination produce bronchial anesthesia without affect blood oxygenation.
* Nebulized Lidocaine solutions should be in range of 1% to 4% without making any side
effects.
* 4% of lidocaine put in nebulized form should be given between 320 and
480 mg of a daily dose every 4–6 hours.
* Some studies showed that lidocaine
inhalation has no side effects on large doses up to 575 mg due to it short half life.
2. The risk of bronchoconstriction is still controversial
* Increasing initial dose 1% till 4% of Nebulized Lidocaine
in 2 ml of saline can reduce lidocaine effect that is bronchospasm
* Typical toxic dose in 9 to 10
mcg/ml will cause muscular fasciculation\tremors\Agitation\convulsions\lidocaine induced
bronchospasm.
* Lidocaine had been safely administered to COVID-19 patients to manage cough
during intubation and extubation, and to prevent the cardiac complications resulted from
chroroquine, hydroxychloroquine, or azithromycin