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To List Members:
 
I agree with Mike Gerardi's comments on nebulized lidocaine (much as I hate
to admit it when I agree with Mike).  However, in our department we use a
4% solution.  We have found that the higher concentration works much better
to get good posterior pharyngeal anesthesia for direct or indirect
laryngoscopy as well as intractable coughing. This solution also works well
for coughing or irritation from inhalation of noxious chemicals such as
pepper gas or ammonia-bleach cleaning mishaps.
 
Al Sacchetti, MD
Our Lady of Lourdes Medical Center
Camden, NJ
 
Alfred Sacchetti
 
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