Efficacy of local versus intravenous lidocaine for cough suppression during flexible bronchoscopy

Daniel Starobin, Gennady Smirnov, Daniel Bendayan, Asher Mazar, Alexander Yarmolovsky, Gershon Fink, Asher Barak, Jacqueline Sulkes, Mordechai R. Kramer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Lidocaine is an anesthetic drug that has been shown to be effective for cough suppression during bronchoscopy. Previous reports have suggested that intravenous lidocaine may be more effective than local lidocaine in preventing broncho-spasm and in attenuating cough. The purpose of this study was to compare the efficacy of lidocaine administered topically or intravenously on cough suppression during elective flexible bronchoscopy. Sixty-four patients undergoing bronchoscopy were assigned randomly to receive lidocaine spray alone, intravenous lidocaine with lidocaine spray, or inhaled nebulized lidocaine solution. All patients received standard sedation with meperidine and midazolam. Cough was scored qualitatively and quantitatively by an independent observer during the procedure. Administration of additional intravenous sedation or intrabronchial lidocaine solution was recorded. The three groups were similar with regard to demographic parameters. Cough scores for the spray, intravenous, and inhaled lidocaine groups were 71.9, 73.4, and 83.7 points respectively (p = 0.87). The patients who received inhaled lidocaine required more intravenous midazolam and intrabronchial lidocaine during the procedure. No significant advantages were found for any of the routes of administration with regard to cough suppression. More patients receiving intravenous lidocaine were drowsy after the procedure. Intravenous lidocaine was without additional benefit in combination with local lidocaine compared with local lidocaine alone for cough suppression during elective bronchoscopy.

Original languageEnglish
Pages (from-to)182-185
Number of pages4
JournalJournal of Bronchology
Issue number3
StatePublished - 2002
Externally publishedYes


  • Anesthesia
  • Flexible bronchoscopy
  • Lidocaine


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