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Background and Objective <p>Intractable cough, affecting 10–50% of terminally ill patients, significantly impairs quality of life. Conventional therapies often fail due to dose-limiting side effects or inadequate efficacy, necessitating alternative treatments. This review evaluates the efficacy, safety, and clinical applicability of nebulized lidocaine for managing intractable cough in hospice care.</p> Methods <p>A systematic literature search (1973–2023) across PubMed, MEDLINE, Embase, and Cochrane Library identified studies on nebulized lidocaine in hospice or palliative populations. Inclusion criteria the Cochrane Risk of Bias Tool and Newcastle–Ottawa Scale. Data on cough reduction, side effects, and dosing were synthesized thematically.</p> Results <p>Among 265 screened studies, 58 met inclusion criteria. Nebulized lidocaine (1–4%) demonstrated rapid cough suppression (within 15&#xa0;min) in 70% of cancer patients, with effects lasting 2–4&#xa0;h. Mild side effects, including oropharyngeal numbness (15%) and bitter taste (10%), were transient. However, 25% of asthmatic patients experienced bronchoconstriction (forced expiratory volume in 1&#xa0;s&#xa0;FEV1FEV1&#xa0;decline ≥ 15%), resolving with bronchodilators. Lidocaine reduced opioid reliance and improved comfort in 80% of cases. Variability in efficacy was noted, with limited benefits in severe chronic obstructive pulmonary disease (COPD) with acute respiratory failure.</p> Conclusion <p>Nebulized lidocaine offers a safe, non-invasive option for intractable cough in hospice care, minimizing systemic side effects. Its rapid action and compatibility with opioid-sparing regimens enhance palliative outcomes. However, cautious use is warranted in asthma and (COPD) due to bronchoconstriction risks. Future research should prioritize standardized dosing, long-term safety, and <i>Randomized controlled trials(</i>RCTs in diverse hospice populations.</p>

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"Nebulized lidocaine for intractable cough in hospice care: a comprehensive review of efficacy, safety, and future perspectives"

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月30日

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  • Jumei Pan,
  • Akhtar Ali Khan,
  • Wenkai Yu,
  • Lei Rui

摘要

Background and Objective

Intractable cough, affecting 10–50% of terminally ill patients, significantly impairs quality of life. Conventional therapies often fail due to dose-limiting side effects or inadequate efficacy, necessitating alternative treatments. This review evaluates the efficacy, safety, and clinical applicability of nebulized lidocaine for managing intractable cough in hospice care.

Methods

A systematic literature search (1973–2023) across PubMed, MEDLINE, Embase, and Cochrane Library identified studies on nebulized lidocaine in hospice or palliative populations. Inclusion criteria the Cochrane Risk of Bias Tool and Newcastle–Ottawa Scale. Data on cough reduction, side effects, and dosing were synthesized thematically.

Results

Among 265 screened studies, 58 met inclusion criteria. Nebulized lidocaine (1–4%) demonstrated rapid cough suppression (within 15 min) in 70% of cancer patients, with effects lasting 2–4 h. Mild side effects, including oropharyngeal numbness (15%) and bitter taste (10%), were transient. However, 25% of asthmatic patients experienced bronchoconstriction (forced expiratory volume in 1 s FEV1FEV1 decline ≥ 15%), resolving with bronchodilators. Lidocaine reduced opioid reliance and improved comfort in 80% of cases. Variability in efficacy was noted, with limited benefits in severe chronic obstructive pulmonary disease (COPD) with acute respiratory failure.

Conclusion

Nebulized lidocaine offers a safe, non-invasive option for intractable cough in hospice care, minimizing systemic side effects. Its rapid action and compatibility with opioid-sparing regimens enhance palliative outcomes. However, cautious use is warranted in asthma and (COPD) due to bronchoconstriction risks. Future research should prioritize standardized dosing, long-term safety, and Randomized controlled trials(RCTs in diverse hospice populations.