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Bronchospasm after intravenous lidocaine.

Bobby R Burches¹, David O Warner

¹Department of Anesthesiology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA.

Anesthesia and Analgesia

|September 23, 2008

Summary

Intravenous lidocaine can cause temporary airway narrowing, specifically bronchospasm, in children with asthma. This adverse event, though transient, highlights a potential risk during medical procedures for asthmatic patients.

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Published on: January 13, 2017

Area of Science:

Anesthesiology
Pediatric Pulmonology
Pharmacology

Background:

Airway management during anesthesia is critical in pediatric patients.
Asthma is a common chronic respiratory disease in children, characterized by airway hyperresponsiveness.
Intravenous lidocaine is frequently used for its anesthetic and antiarrhythmic properties, including facilitating endotracheal intubation.

Observation:

A 17-month-old female with mild intermittent asthma experienced acute bronchospasm immediately following intravenous lidocaine administration (1.5 mg/kg) for endotracheal intubation.
The patient exhibited diffuse bilateral expiratory wheezes and a significant increase in peak inspiratory pressure.
The bronchospastic episode resolved spontaneously within approximately 5 minutes, allowing for an otherwise uneventful anesthetic course.

Findings:

The observed transient bronchospasm in an asthmatic child following IV lidocaine administration aligns with emerging clinical evidence.
Intravenous lidocaine may induce airway narrowing in patients with asthma, a condition associated with heightened airway reactivity.
This case underscores the potential for IV lidocaine to precipitate bronchospasm in susceptible pediatric patients.

Implications:

Clinicians administering intravenous lidocaine to pediatric asthmatic patients should be aware of the potential for bronchospasm.
Careful patient selection and monitoring are recommended when using IV lidocaine in asthmatic individuals.
Further research is warranted to elucidate the mechanisms and prevalence of IV lidocaine-induced airway narrowing in asthmatics.