PT  - JOURNAL ARTICLE
AU  - Ryan Grell
TI  - Addition of nebulised lidocaine to prevent refractory bronchospasms in a patient receiving serial bronchoscopies
AID  - 10.1136/bcr-2022-253592
DP  - 2023 Feb 01
TA  - BMJ Case Reports
PG  - e253592
VI  - 16
IP  - 2
4099  - http://casereports.bmj.com/content/16/2/e253592.short
4100  - http://casereports.bmj.com/content/16/2/e253592.full
SO  - BMJ Case Reports2023 Feb 01; 16
AB  - A patient in his 20s with a history of granulomatosis with polyangiitis required 15 bronchoscopies with dilations in 1 year due to bronchial fibrosis and secretions leading to worsening shortness of breath. During these bronchoscopies, the patient experienced increasingly severe bronchospasms refractory to conventional preventative and treatment methodologies leading to prolonged hypoxia, reintubations and ICU admissions. During his 8th to 15th bronchoscopies, nebulised lidocaine was added to the pretreatment regimen, which eliminated perioperative bronchospasms and allowed for the elimination of all other adjunctive preventative treatments. This case highlights the novel perioperative use of nebulised lidocaine, in combination with nebulised albuterol and intravenous hydrocortisone, to successfully prevent previously refractory bronchospasms in a patient undergoing a general anaesthetic.