bronchoscopy lidocaine method and dosing

Materials Needed

  • lidocaine 2% solution
  • lidocaine 2% jelly (6 or 12 cc)
  • 4 10 cc slip tip syringe
  • 5 20 cc slip tip syringe
  • 4 x 4 gauze
  • atomizer device
  • 2 qtips

Details

  • Total lidocaine dose can be given is 8 mg/kg
    • approximately 29 cc of a 2% solution for a 70 kg patient 12
    • 1 cc of lidocaine is 20 mg for 2% solution
  • use lidocaine 2% solution for atomizer and Jackson forceps
  • for nebulizing: 5 cc nebulize with face mask3
  • atomizer: draw up 4-5 cc total
    • give each nostril 1 cc x2 for total of 4 cc
    • give back of throat 1 cc
    • this would give total of 5 cc lidocaine, or 100 mg
    • alternatively can give 4 cc in oropharynx if bronching through nose
  • use lidocaine 2% jelly for qtips (6 or 12 cc)
  • for cords and carina: use 10 cc syringe x4 for total of 12 cc
    • use 3 cc x 2 both for cords
    • use 3 cc x 2 at the carina
  • total dose: 23-29 cc
  • toxicity for over dose:

Footnotes

  1. Diagnostic Bronchoscopy - Basic Techniques ↩

  2. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults ↩

  3. Regional and Topical Anesthesia for Awake Endotracheal Intubation ↩