Efficacy of adjuvant treatment with nebulized lidocaine in improving clinical and pulmonary function parameters of acute asthma attacks: a randomized double-blind clinical trial

Abstract

Efficient novel medications can facilitate the acute phase of asthma treatment. The aim of this study was to investigate whether nebulized lidocaine as an additional treatment can improve clinical, forced expiratory volume in 1 s (FEV1), and peak expiratory flow rate (PEFR) indexes during an acute asthma attack. A double-blind randomized clinical trial was conducted in 60 adults with possible acute asthma attack who had been referred to the emergency department of our hospital. Patients were randomized into control and treatment groups. The treatment group received nebulized lidocaine 200 mg at 0, 20, 40, and 60 min after arrival + standard treatment with a single dose of oral prednisolone 50 mg at arrival + nebulized albuterol 2.5 mg and nebulized ipratropium bromide 0.5 mg at 0, 20, 40, and 60 min. The control group received only standard treatment. Clinical severity (Borg Dyspnea Scale), FEV1, and PEFR indexes and hemodynamic parameters were recorded at arrival and at 20-min intervals for 60 min after arrival. Mean PEFR and FEV1 increased significantly from baseline in both treatment groups, with no significant between-group differences (BGDs). The BGDs in respiratory rate and hemodynamic parameters (heart rate, systolic and diastolic blood pressure, and oxygen saturation) at 0, 20, 40, and 60 min after arrival were not significant (p > 0.05). Finally, the severity of dyspnea (Borg Dyspnea Scale) did not differ between the two groups at discharge (0.68 vs. 0.76; p = 0.566). The results of this study found no benefit from adding nebulized lidocaine to the standard treatment of asthma attacks. Our data reject any benefits for the efficacy of nebulized lidocaine, at least for short-term use in the acute phase of an asthma attack. Research on the efficacy of nebulized lidocaine during the course of an acute asthma attack is limited, and more research is required to clarify the detailed clinical effects.