Yung, Chee Tien
(2007)
Nebulized combined lignocaine and
Salbutamol in treatment of acute asthma
(A Pilot Study).
Masters thesis, Universiti Sains Malaysia.
Abstract
Management of asthma in Emergency. Department remains a challenge to all
Emergency Physician and Allied Health Personnel. Various modality of treatment has
surfaced since the last decade and lately, anaestheti~ medications have found a place in
treatment of mild to moderate asthma patients. Anaesthetic medications have long been
found to have direct effect on airway smooth muscle and it causes relaxation of the
bronchial smooth muscles. The anaesthetic medication in question is Lignocaine.
Lignocaine is an local anaesthetic and anti-arrythmic medication that is easily available.
It has a rapid onset of action and short duration of action. Lately it has been found to have
property to attenuate reflex bronchoconstriction and also anti-inflammatory.
STUDY OBJECTIVE
The objective of this study is to compare the result of relief of
bronchoconstrictions in patients with acute asthma when they are given either combined
nebulized lignocaine & salbutamol or salbutamol only. This study also would like to
document the side effects of combined nebulized lignocaine and salbutamol.
METHOD
A prospective study was conducted on 50 patients who had come to the emergency
department and required treatment for acute exacerbation of mild to moderate asthma.
Patients who fulfilled the criterias for inclusion were randomized to receive either plain
salbutamol or combined salbutamol with lignocaine nebulized treatment. Measurements
of peak expiratory flow rate and other clinical datas such as blood pressure, pulse rate,
respiratory rate and oxygen saturation level will be t*en in intervals.
RESULTS
The results from 50 patients requiring treatment for acute exacerbation of asthma showed
that there were no significant difference between those randomized to receive plain
salbutamol treatment and those receiving combined salbutamol and lignocaine nebulizers.
At 15 minutes of treatment, the mean percentage of increased PEFR value of 20.92
±2S.23 (Single) and IS.01 ± 22.09 (Combined) . The p value seen was 0.687 at 15
minutes interval of treatment. Even at 30 minutes of treatment shows the mean
percentage value of increased PEFR at 33.91 ± 34.79 (Single) and 36.02 ± 41.15
(Combined) with p value of 0.846. Out of 25 patients who were given combined
saJbutamoJ and lignocaine treatment, 16 patients experienced numbness of the oral cavity
and 9 patients experienced both bitterness taste and numbmess of the oral cavity.
CONCLUSION
Combined salbutamol and lignocaine did not have a better relief of bronchoconstriction
as compared to salbutamol nebulization in mild to moderate asthma. The expected side
effects of lignocaine were encountered and there were no new ones.
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