Intravenous lidocaine and oral mexiletine block reflex bronchoconstriction in asthmatic subjects

Harald Groeben, W. M. Foster, Robert Howard Brown

Research output: Contribution to journalArticle

Abstract

Stimulation of the airways of asthmatic individuals causes severe bronchoconstriction, which is in part neurally mediated via the vagus nerve. Local anesthetics are commonly administered to prevent this reflex-induced bronchoconstriction. Therefore, in a double-blind, placebo-controlled prospective study, we tested the effectiveness of oral mexiletine and intravenous lidocaine at blocking histamine-induced reflex bronchoconstriction. Fifteen subjects with mild asthma were selected (for whom the provocative concentration of histamine aerosol causing a 20% decrease in FEV1 (PC20) was less than 18 mg/ml). Subsequently, the subjects were pretreated with oral mexiletine, intravenous lidocaine, or placebo, and the histamine challenges were repeated. The baseline PC20 for histamine was 8.8 ± 1.8 mg/ml. Mexiletine and lidocaine at therapeutic serum concentrations blocked reflex bronchoconstriction. Oral mexiletine increased the PC20 to 21.1 ± 5.0 mg/ml (serum concentration: 0.7 ± 0.05 μg/ml). Likewise, intravenous lidocaine increased the PC20 to 24.5 ± 4.9 mg/ml (serum concentration: 2.6 ± 0.15 μg/ml). Oral mexiletine and intravenous lidocaine block reflex-induced bronchoconstriction. Furthermore, mexiletine may have additional airway benefits when selected for the treatment of dysrhythmias or chronic pain in patients with coexisting lung diseases.

Original languageEnglish (US)
Pages (from-to)885-888
Number of pages4
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume154
Issue number4 I
StatePublished - 1996

Fingerprint

Mexiletine
Bronchoconstriction
Lidocaine
Reflex
Histamine
Serum
Placebos
Vagus Nerve
Local Anesthetics
Aerosols
Chronic Pain
Lung Diseases
Asthma
Prospective Studies
Therapeutics

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Intravenous lidocaine and oral mexiletine block reflex bronchoconstriction in asthmatic subjects. / Groeben, Harald; Foster, W. M.; Brown, Robert Howard.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 154, No. 4 I, 1996, p. 885-888.

Research output: Contribution to journalArticle

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