Lignocaine use in respiratory viruses

Amjid Hammodi

Orthopedic Surgeon, Baghdad, Iraq; E-mail: amjidhammodi@yahoo.com

Citation: Hammodi A. Lignocaine use in respiratory viruses. Anaesth. pain and intensive care 2020;24(4);472.
DOI: 10.35975/apic.v24i4.1332


Following the publication of the article entitled, ‘Lignocaine’s substantial role in COVID-19 management: potential remedial and therapeutic implications’, authored by Nasser Ali Malik, Amjid Hammodi and Dayanidhi Jaiswara, published in the Anaesthesia, Pain and Intensive Care; 21(1);59-63, 2020, I would like to suggest a revolutionary idea that could help control the spread of respiratory viruses from person to person, achieve potential prophylaxis against them and even could be used as a treatment for mild to moderately infected cases.
The idea is to use intranasal lignocaine gel to strengthen the sodium channels of the nasal and nasopharyngeal mucosal cells, as it has emerged recently that targeting ion channels of the host cells can impede virus life cycle. Theoretically, it can produce prophylaxis and also can be used as a treatment.  The lignocaine gel can be applied to the nasal septum and lateral walls. The lignocaine will diffuse through the mucosa to the myelin sheaths of the nasopalatine nerve (branch of the maxillary nerve) and nasociliary nerve (branch of the ophthalmic nerve), and to the myelin sheaths of the maxillary and vagus nerves. It will eventually strengthen the nasopharyngeal mucosal cell sodium channels along with nasal mucosal cells. The theory of the ability of lipid soluble lignocaine to travel through the uninterrupted myelin sheaths of different nerves, as myelin sheaths are mainly formed off lipids themselves, has been adopted by the author as a hypothesis to explain the ability of a distal nerve block to relieve pain caused by a more proximal cause (the anatomical gates of sodium channels blockers). Thus, for prophylaxis against viral respiratory infections, applying the lignocaine gel to the nasal cavity twice daily will theoretically suffice; while infected cases can be treated with more frequent applications of the gel, up to every hour and then reducing the frequency gradually as patient’s symptoms improve.
This prophecy needs to undergo clinical trials to prove or refute the benefits.

Reference:

Malik NA, Lignocaine’s substantial role in COVID-19 management: potential remedial and therapeutic implications. Anaesth. pain & intensive care 2019;23(1):84-91 [Free full text] DOI: 10.35975/apic.v24i1.122