A note on nebulized Lidocaine treatment in intractable cough in ICU

Nebulized lidocaine appears to be well tolerated and effective in the treatment of intractable cough particularly near the end of life. One advantage to nebulized lidocaine is the lack of significant side effects. Patients can be given 5 mL of 2% lidocaine solution with 4–6 L/min oxygen until completion of the nebulized therapy, typically over 3–5 minutes. Patients should be encouraged to maintain head elevation for at least 30 minutes post treatment and to refrain from eating or drinking for 40 minutes after the treatment completed.