Intravenous lidocaine and oral mexiletine block reflex bronchoconstriction in asthmatic subjects

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

Research output: Contribution to journalArticlepeer-review


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
Issue number4 I
StatePublished - 1996

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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