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J Allergy Clin Immunol. 2004 May;113(5):853-9.

Treatment of asthma with nebulized lidocaine: a randomized, placebo-controlled study.

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1
Department of Internal Medicine, Division of Allergic Diseases, Mayo Clinic and Foundation, Mayo Graduate School of Medicine, Rochester, MN 55905, USA.

Abstract

BACKGROUND:

In 2 prior uncontrolled studies, nebulized lidocaine reduced oral glucocorticoid use in patients with severe glucocorticoid-dependent asthma.

OBJECTIVE:

We tested the safety and efficacy of nebulized lidocaine in a randomized, placebo-controlled study in patients with mild-to-moderate asthma.

METHODS:

We recruited 50 subjects (25 receiving lidocaine and 25 receiving placebo); all had a prebronchodilator FEV(1) of 64% to 125% of predicted normal value and were treated with daily inhaled glucocorticoids (but not systemic glucocorticoids) and bronchodilators for at least 2 months. Before treatment, subjects monitored their symptoms and peak flow values and maintained their medications for 2 weeks. At initiation, subjects inhaled either nebulized placebo (saline) or lidocaine (4%, 100 mg) 4 times daily. All subjects were instructed to reduce their inhaled glucocorticoid dosage by one half each week for 3 weeks and to discontinue glucocorticoid treatment at week 4. The subjects continued the nebulized lidocaine or placebo for a total of 8 weeks, monitored their symptoms, and used bronchodilators to control symptoms.

RESULTS:

Indicators of asthma severity showed benefit for the lidocaine-treated group: changes in FEV(1) (P < or =.001), nighttime awakenings (P < or =.02), symptoms (P < or =.010), bronchodilator use (P < or =.010), and blood eosinophil counts (P < or =.020). Subjects in both groups reduced use of inhaled glucocorticoids comparably. Subjects receiving nebulized placebo showed increases in their symptom scores, bronchodilator use (P < or =.05 for both), and blood eosinophil counts (P < or =.01) and decreases in FEV(1) (P < or =.001).

CONCLUSION:

Nebulized lidocaine provided effective and safe therapy in subjects with mild-to-moderate asthma.

PMID:
15131566
DOI:
10.1016/j.jaci.2004.02.039
[Indexed for MEDLINE]
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