Lidocaine concentrations in bronchoscopic specimens.
We measured lidocaine concentrations in bronchoscopic specimens and found that bronchoalveolar lavage (BAL) concentrations (16 +/- 7 micrograms/ml) were lower than those in bronchial washings (967 +/- 379 micrograms/ml [p less than 0.001]). Lidocaine concentrations in bronchial washings obtained "early" (991 +/- 505 micrograms/ml) compared with "late" (943 +/- 580 micrograms/ml) in the procedure did not differ (p = NS). High lidocaine concentrations sufficient to inhibit growth in culture of mycobacterial and fungal pathogens (greater than 5,000 micrograms/ml) occurred in one early and two late bronchial washings but no BAL specimens. No correlation between lidocaine dose and measured concentrations was noted in any specimen category; however, highest bronchial washing concentrations occurred with the use of greater than 250 mg of lidocaine. We conclude that BAL specimens are suitable for culturing pathogens that may be inhibited by lidocaine. Furthermore, collecting bronchial washings late in the procedure or limiting the lidocaine dosage do not reliably decrease measured lidocaine concentrations.
Strange
C
C
Department of Medicine, Medical University of South Carolina, Charleston 29425.
Barbarash
R A
RA
Heffner
J E
JE
D001992:Bronchoalveolar Lavage Fluid / Q000032:analysis*; D001999:Bronchoscopy / Q000379:methods; D004305:Dose-Response Relationship, Drug; D005336:Fiber Optic Technology; D006801:Humans; D008012:Lidocaine / Q000032:analysis*; D013048:Specimen Handling / Q000379:methods; D013997:Time Factors
D008012:Lidocaine