Lidocaine nebulization for airway topical anesthesia can be improved by diminish ex-cannula lost and alkalization

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses Pub Date : 2024-11-08 DOI:10.1016/j.mehy.2024.111511

Ran Duan , Yingying Zhang , Yanxin Cheng , Lei Zhang , Senming Zhao

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引用次数: 0

Abstract

Lidocaine nebulization is noninvasive, safe, and easy to perform. However, it does not provide adequate anesthesia due to the following reasons: 1. There is a high wastage of lidocaine aerosol, with at least 70 % of the lidocaine aerosol being lost from the cannula. This loss of lidocaine results in a lower amount of inhaled lidocaine, which is insufficient to provide adequate anesthesia. 2. The commercial lidocaine preparation has a low penetrating potency. The onset of anesthesia is directly related to the amount of local anesthetic in the lipid-soluble form. However, there are only a few lipid-soluble prototypes in the commercially available lidocaine cartridges. This is because the lidocaine is purposely formulated as acidic solutions (with pH levels between 3.5 and 5.5) in order to enhance the solubility and stability of the anesthetic salts. To address these issues and improve lidocaine anesthesia potency while reducing wastage, a “Y” type cannula was used for aerosol inhalation. Additionally, 1/5 vol of 5 % sodium bicarbonate solution was added to 2 % lidocaine to enhance the pH value to 7.2. This alkalized lidocaine nebulization provides an effective topical anesthesia for bronchoscopy.

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利多卡因雾化用于气道局部麻醉可通过减少呼气管外损失和碱化得到改善

利多卡因雾化疗法是一种无创、安全且易于操作的方法。但是，由于以下原因，它不能提供充分的麻醉：1.利多卡因气溶胶的损耗率很高，至少有 70% 的利多卡因气溶胶会从插管中流失。利多卡因的流失导致吸入的利多卡因量减少，不足以提供充分的麻醉。2.2. 商用利多卡因制剂的穿透力较低。麻醉的开始与脂溶性局麻药的量直接相关。然而，市售利多卡因盒中仅有少数几种脂溶性原型。这是因为利多卡因被特意配制成酸性溶液（pH 值在 3.5 到 5.5 之间），以提高麻醉盐的溶解度和稳定性。为了解决这些问题，提高利多卡因的麻醉效力，同时减少浪费，使用了 "Y "型插管进行气溶胶吸入。此外，在 2% 的利多卡因中加入 1/5 体积的 5% 碳酸氢钠溶液，将 pH 值提高到 7.2。这种碱化的利多卡因雾化为支气管镜检查提供了有效的局部麻醉。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical hypotheses 医学-医学：研究与实验

CiteScore

10.60

自引率

2.10%

发文量

167

审稿时长

60 days

期刊介绍： Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. The Aims and Scope of Medical Hypotheses are no different now from what was proposed by the founder of the journal, the late Dr David Horrobin. In his introduction to the first issue of the Journal, he asks ''what sorts of papers will be published in Medical Hypotheses? and goes on to answer ''Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary''. (Horrobin DF, 1975 Ideas in Biomedical Science: Reasons for the foundation of Medical Hypotheses. Medical Hypotheses Volume 1, Issue 1, January-February 1975, Pages 1-2.). Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations.