Mode of Delivery of Anesthetic
The time taken to properly anesthetize and prepare the patient always pay off.
The most discomfort occurs during anesthetization. However, the procedure itself goes
smoothly, thanks to topical anesthesia.
You will quickly realize that no two persons performing the procedure are
exactly alike. Learn good habits in the beginning and they will stay with you.
Methods of delivering anesthetic to the larynx are:
- Nebulization:
Lidocaine can be delivered to the larynx by nebulization. I have used this technique many
times.
- Indirect Laryngoscopy:
In the past, I used indirect laryngoscopy to deliver lidocaine into the larynx. I do not
any longer.
- Blind Method:
Hold the epiglottis forward with index finger, position the curved nozzle beyond and
instill xylocaine directly into the larynx. The patient will cough if you succeed. I find
this technique easy and it accomplishes the task well.
- Direct Method:
Lidocaine can be instilled into the larynx under direct vision by fiberoptic bronchoscope.
I do this routinely, even after anesthetizing the larynx by other methods.