Panprapakorn K, et al. - Experts aspired to explore if the use of lidocaine together with normal sterile saline (NSS) nebulization through a tracheostoma would be more effective at decreasing the cough and pain symptoms compared with the standard NSS nebulization. This investigation was performed in King Chulalongkorn Memorial Hospital between June 2016 and June 2017. For this prospective, cross-over study, the first group received 4 mL of 1% lidocaine without adrenaline mixed with 1 ml of NSS (referred to as lidocaine-NSS) via a nebulizer at 10 a.m. on the next day after surgery and then the 5 mL NSS nebulizer at 6 p.m. On the other hand, the second group received the NSS nebulizer first at 10 a.m. Study participants included 32 tracheostomy patients (29 patients with upper airway obstruction by cancer and three with bilateral vocal fold paralysis). According to findings, the lidocaine-NSS nebulizer in early postoperative tracheostomy patients caused a significant reduction in cough and pain, especially for the cough symptom, compared with using only NSS. No complications or side effects have been found with lidocaine.