title: Acute respiratory distress syndrome after airway anesthesia with lidocaine.
abstract: Adequate anesthesia of the upper and proximal lower airways is a critical prerequisite for a smooth and successful bronchoscopic procedure. Lidocaine is the most commonly used local anesthetic agent for flexible bronchoscopy. Adverse reactions to this agent have rarely been reported. Nevertheless, we recently observed a life-threatening reaction to airway lidocaine anesthesia in a 33-year-old man who was to undergo flexible bronchoscopy for the evaluation of an intrathoracic lymphadenopathy. Before the procedure, the patient developed noncardiogenic pulmonary edema. Only 2 such cases after airway anesthesia with nontoxic doses of lidocaine for a bronchoscopic procedure have been reported in the literature. Unlike in these cases, the episode was brief and self-limiting, with adverse reaction confined to the respiratory tract without development of shock or systemic involvement.
authors.affiliation: Department of Pneumology, Service of Thoracic Endoscopy, General Hospital of Crema, Crema, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Dʼelia
authors.forename: Loredana
authors.initials: L
authors.lastname: Ghio