Stefanie Meyle,

Lidocaine can effectively reduce coughing without any other significant side-effects:

Article Lidocaine during intubation and extubation in patients with ...

https://bjanaesthesia.org/article/S0007-0912(19)30971-7/fulltext

https://bjanaesthesia.org/article/S0007-0912(20)30098-2/fulltext

Lidocain? Has not any action mecanism that lidocain to kill virus or to diminuish pulmonary edema.

I agree with Jes Jose inhaled local anaesthetic is likely to suppress airway reflexes. This may increase risk of transmission of SARS-CoV-2 from the upper respiratory tract to the lower respiratory tract.

Futhermore, at present inhaled lidocaine and procaine would have to be administered via nebuliser. This is an aerosol generating procedure that would increase risk to healthcare professionals.

Dr Jes Jose has raised a pertinent concern which has been explained well by Dr Rajkumar Rajendram

Well discussed

Thank you for your answers.

The duration of Procain 1% anesthesia is a lot less than Lidocain 1%, the anti-imflammatory effect of Procain 1% seems to be better than Lidocain 1% according to this very old paper from the 70ies. Would 15 min of Procain 1% effect also have the same risks you described above?

And why do pneumologists tell me, that they use Lidocain 1% Inhalation before bronchoscopy. If there would be such a great reflex risk, wouldn't they all aspirate in the procedure?

And what about constructing a Dose-Aerosol with Procain 1% like it exists for Ventolin? This would be personally used and not spread in the room?

Thank you for the discussion!

Hello: I STRONGLY suggest that you look at the Facebook and Linked In posts of Dr. David Moskowitz (Gemomed Inc and Practicing Nephrologist). The COVID-19 leads to what can be considered a slow rolling form of asthma. There is a lot of information developing within the last two weeks e.g. from Spain and California that EARLY on you need to treat with steriods like prednisone. This appears to stop the cytokine storm which appears to be the feature of patients who go bad suddenly. Another aspect of the disease is that the virus enters the cells via the ACE2 receptor. When this happens ACE2 on cells is actually DOWNREGULATED. At the same time inflammation is increased both because the ACE2 receptor when complexed to the AT1R potentiates inflammation and also because the the endocytosis-lysosomal degradation the of ACE2 receptor, which should effect the intracellular release of NO with resultant recruitment of the protein AT2R to the cell membrane does not occur. Normally AT2R would complex membrane ACE2 receptor and potentiate conversion of inflammation promoting Angiotensin II to Ang 1-7 resulting in a regulation of the inflammation in the lungs. Because this does not happen you have an out of control inflammation response. This leads to fluid infiltrate in the lung, especially in the lower lung, peeling off of pneuomocytes and other cells from the basement membrane, increase tissue fluid permeability etc. It also leads to lung fibrosis due to MMPs which remodel tissue in order to allow influx of immune cells. Another aspect of this is that the acquired immunity takes at least several (more like 9-14) days to develop. Therefore innate immunity via NK cells, dendritic cells etc has to do the job. Dr. Reza Nejat of Bazarganan Hospital in Tehran has suggested that dendritic cells actually vector the virus to the lung; so there is at least some aspect of immune evasion going on. The physical manifestations of lung tissue attack in COVID-19 are apparent early on in the infection as has been shown by a number of groups. There is a disseminated ground glass appearance and within not much time one can see areas of consolidation indicative of fluid infiltrate, fibrosis etc. Once this starts you are in the danger zone. So I tend to think that Lidocaine is more a short term solution vs the kind of treatments which get at the deep[[er etiology of the disease.

Thank You.

You can read this article about cytokine storm:

https://www.euronews.com/2020/04/09/understanding-covid-19-the-unknown-disease-with-multiple-faces

Thank you Edmund Marinelli for your answer.

I tried to promote PROCAIN 1% inhalation or treatment, I added Lidocain 1% because most colleagues prefer Lidocain 1%. And I postulate that you get a very similar answer of your immune system if you administer Procain 1% (Ganglion stellatum injection, inhalation with Dose Aerosol, that does not exist so far, as I know, Procain iv) compared to steroids. I know, that Lidocain and Procain can do arrhythmias, but if you look at the other side effects Procain (and Lidocain) wins. That is my opinion, that is what I see in my part time ENT world every time I do Procain 1% injections or if I prescribe Procain 1% nasal spray for chronic sinusitis, pollen allergy or privinism. But I have no experience with Covid-19 patients. I just wanted to share my thoughts!

Ok. Thank You

SARS-CoV-2 can be detected in the air up to 4 meters from COVID-19 patients

A recent study from Wuhan China indicates that SARS-CoV-2 virus is widely distributed on floors, computer mice, trash cans, and sickbed handrails and can be detected in air ≈4 meters from COVID-19 patients.

https://wwwnc.cdc.gov/eid/article/26/7/20-0885_article

Thank You

It is not surprising that the virus can be transmitted 4 meters from patients. I believe the number quoted is low. It has been known for a very long time that aerosols from a sneeze can travel at least 30 feet ( the number in my memory is actually 37 feet). By the way one should realize that there is a percentile issue here. i doubt that at 30 or 37 feet there is an abrupt cutoff. There is a statistical probably of even larger distances. Think about what happens near the sea. People use the expression ‘the salt air’ for a reason. The ocean waves breaking inshore generate aerosols that can travel for considerable distances and one can smell the salt air. Metal fixtures corrode more readily in these environments due to the salt in the aerosols which eventually deposit on them. So we have another clean up standard that needs to be met with Covid-19.

Look for this article:

https://www.thegreenjournal.com/article/S0167-8140(20)30185-7/fulltext

Dear all

Plagriasm as we all agree is very bad.

using nebulized lignocaine to treat Covid19 was our idea and we published first about it in April 2020

this is the link

https://www.apicareonline.com/index.php/APIC/article/view/1227

it is very sad that many are claiming our work.

Thank you

Dr. Amjid Hammodi

Dear Amjid Hammodi: Thank you for your answer. I did not know about your work. I am just happy that it was published and that it helps patients! No plagiarism, just a question from an interested ENT. Also look at my question about block of ganglion stellatum March 24. There are actually people in this world who only want to share ideas.

And by the way: reading the discussion above and talking to pneumology specialists, who actually treated and treat Covid-19 patients, the aerosol problem should really be taken in account. Nebulizing with open applicators, as I understood it, is not a good idea in Covid-19 times. The only way in my opinion to safely use it for patients is via dose aerosol and as far as I know a dose aerosol nebulizer for Lidocain, like in the case of ventolin, does not exist so far. That would be an option for single patients to use their own hand held dose aerosol nebulizer without risking aerosols to spread. So feel free to get a pharmacist to produce it. It would be a great help in my point of view. I could not find somebody to produce it.

Pardon me

there is a guy in the USA published the same idea 45 days after we published our paper and it does not feel good.

In regards to safety issues of using it, I believe patients can be taught to use it when they are in closed room with some extracting ventilation in the room.

some doctors are going to use intravenous lignocain.

I beg your pardon again

Look this link:

https://www.drugs.com/news/mutation-helps-coronavirus-infect-more-human-cells-study-shows-90856.html

The only way ever to be successful to treat Covid19 is nasal lignocaine for mild to moderate cases and nebulised lignocaine for SPO2 below 90%

no vaccines will work

009647817749052

whats up me and I will send details and proofs

It definitely works for any viral, bacterial and fungi respiratory tract infection.

moreover, it will prove very successful in treating lung Tuberculosis and cancer.

Sodium channels concept and era

everything in medicine will change

Follow up the Covid19 curves in Iraq.

THE GAME IS OVER

009647817749052

whatsup me with your name and country and I will send you the protocols for Covid19 if you are really keen to save lives.

There are people, who do not use whatsapp! I am not a fan of Mr. Zuckerberg. Thank you very much for your interest to share information, an Email address would be much more helpful.

Best regards

Stefanie Meyle

No problem Sir

[email protected]

still I am happy to help those who Wish to contact me through my mobile

Since you are a specialist in ENT if I am not mistake.

many conditions in ENT can be treated by nasal lignocaine only

for example because the list is long:

Tonsillitis whether viral or bacterial can be treated with nasal lignocaine only.

sodium channels concept and era

https://youtu.be/BTYcVHvEhz0

Dear Amjid Hammodi,

even better than Lignocaine is Procain 1% as a nasal spray, I already use this for 3 years in patients with chronic sinusitis, privinism, allergic rhinitis, viral rhinitis and so on. And not only me, there are colleagues, mainly GPs, that are specialized in neural therapy, who use this already for decades! The amount of corticoid nasal spray needed is a lot less in these patients I see (sorry, no EBM, just empirical). And there are two pharmacies in Switzerland, that are officially producing Procain 1% nasal spray.

Best regards

Yes why not

Use it alone for medical conditions like sinusitis and many others but do not use steroids with it as the latter decreases the efficacy of a Sodium channel blocker And a Sodium channels blocker acts as a steroid or even i think it poses higher antiinflammatory effect than steroids.

use it for Covid19 patients.

I have to stress one point which is usually not heeded by doctors: Do not use steroid, antibioticS, antivirals or plasma for Covid19 patients when you are using A sodium channels blockers as using them will definitely and by clear practice with Covid19 patients will lead to higher mortality rates and less favourable outcome with a sodium channels blocker.

Yes neural therapy has been there for a very long time, but the anatomical gates of sodium channels blockers offered a more clear picture of how scientifically it works and moreover it is regarded as a revolution of neural therapy and that need a lot of effort to explain it.

please see the following papers to get an idea of the subject

Publications

1/ The Anatomical Gates of sodium channels

https://www.apicareonline.com/index.php/APIC/article/view/1077/1795

2/Coccydynia

https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-019-2275-5

3/Fibromyalgia

https://www.recentscientific.com/sites/default/files/14640-A-2019.pdf

4/Temporomandibular disorders

https://www.ecronicon.com/ecor/pdf/ECOR-10-00479.pdf

5/ The anatomical gates of the upper limbs

https://www.ecronicon.com/ecor/pdf/ECOR-11-00600.pdf

6/ Nebulised lignocaine for Covid19

https://www.apicareonline.com/index.php/APIC/article/view/1227/2005

thanks

Dr. Amjid Hammodi

Baghdad, Iraq

Role for xylocain in pregnant covid women

And in patients with atrial fibrillation

Safe in pregnancy

I strongly expect it, Nasal lignocaine or procaine, to be the future treatment of heart dysrythmia and all other drugs are expected to be thrown to the trash bin. Needs studies to confirm this.

Lignocaine/Procaine have documented anti-inflammatory properties , other than this ligocaine is also class II-b anti arrthymic drug. Trials on Animals have shown that in asthmatic patients it not only reduces lung epithelial inflammation but also reduces mucous produced and also reverses fibrosis.

Now the mechanism behind this as Explained by worth Dr Amjid hammodi sir , the Sodium gated ion channels.

The lung epithelium amiloride sensitive ENaC are disruppted by SARSCOV virus directly and directly by causing injury to epithelium which leads cytokine storm which again target the ENaC and thus fluid accumulates in the epithelium which hinders the gasseous exchange and so....

What Lignocaince does is that it repolarizes the ENaC , and reverses all the above mechanism.

Concept is simple if Lignocaine is given in low concentrations it acts as repolrizing agemt.

Link to the study published done Dr Amjid sie , me and dr Daya

doi.org/10.35975/apic.v24i1.1227

I like to know if lidocaine protective or treatment for Covid-19

Nebulized Lidocaine is part management of CoVID 19 treatment ,

Application of 2% Lignocaine gel in the nostrils can work both ad prophylactic and as part the management regimin

But according to the medical literature, corticosteroid drugs reduce immunity

Dear colleague Al-Masoudi, I do not understand your comment: Do you compare Lidocain, Lignocaine or Procain to corticosteroids or do you just wanted to make a statement to corticosteroids? Because substances with the ending -cain are local anaesthetics and have nothing to do with corticosteroids..