• Reg Anesth Pain Med · Sep 1999

    Case Reports

    Disappearance of wheezing during epidural lidocaine anesthesia in a patient with bronchial asthma.

    • S Shono, K Higa, I Harasawa, H Sugano, and K Dan.
    • Department of Anesthesiology, School of Medicine, Fukuoka University, Japan.
    • Reg Anesth Pain Med. 1999 Sep 1; 24 (5): 463-6.

    Background And ObjectivesLocal anesthetics in blood absorbed from the epidural space attenuate bronchial hyperreactivity to chemical stimuli. However, it is not documented whether local anesthetics at clinically relevant concentrations improve active wheezing in patients with bronchial asthma.Case ReportWe managed a 60-year-old man with bronchial asthma and active wheezing under continuous epidural anesthesia using plain lidocaine. The wheezing gradually diminished 20 minutes after the epidural injection of 13 mL 2% lidocaine and completely disappeared over 155 minutes during continuous epidural injection of 2% lidocaine (6 mL/h). The plasma concentrations of lidocaine in arterial blood during the epidural anesthesia ranged from 2.5 to 3.9 microg/mL. Wheezing reappeared 55 minutes after termination of the continuous epidural injection of lidocaine. The plasma concentration of lidocaine at this time was 1.9 microg/mL.ConclusionsAt clinically relevant concentrations, lidocaine in the blood absorbed from the epidural space may improve bronchospasm in patients with bronchial asthma.

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