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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
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Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

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Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Related Experiment Video

Updated: Mar 18, 2026

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
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Local Anaesthesia for Fiberoptic Intubation : A Comparison of Three Techniques.

N Sethi1, V K Tarneja2, T P Madhusudanan3

  • 1Classified Specialist (Anaesthesia and Paediatric Anaesthesia), Army Hospital (R & R), Delhi Cantt.

Medical Journal, Armed Forces India
|July 14, 2016
PubMed
Summary

The "spray as you go" technique for airway anesthesia using lignocaine during fiberoptic intubation resulted in better patient comfort and shorter procedure times compared to transtracheal injection or nebulization.

Keywords:
Awake intubationDifficult airwayFiberoptic intubation

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Guidelines for Elective Pediatric Fiberoptic Intubation
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Guidelines for Elective Pediatric Fiberoptic Intubation
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Guidelines for Elective Pediatric Fiberoptic Intubation

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Area of Science:

  • Anesthesiology
  • Airway Management
  • Local Anesthesia

Background:

  • Effective local anesthesia is crucial for successful fiberoptic-guided intubation.
  • This study aimed to compare three distinct airway anesthesia methods.

Purpose of the Study:

  • To compare the efficacy and patient/endoscopist preference of three local anesthesia techniques for fiberoptic intubation.

Main Methods:

  • 60 adult patients underwent fiberoptic intubation after sedation and airway anesthesia.
  • Three groups received 4% lignocaine via: transtracheal injection (Group A), 'spray as you go' technique with intubating fiberscope (Group B), or nebulization (Group C).
  • Patient and endoscopist visual analog scale (VAS) scores, coughing, choking, stridor, anesthetic usage, and intubation times were recorded.

Main Results:

  • Group B demonstrated superior visual analog scale (VAS) scores and reduced intubation times.
  • Patients in Group B experienced significantly less coughing and choking.
  • Endoscopists also expressed a preference for the 'spray as you go' technique (Group B).

Conclusions:

  • The 'spray as you go' technique is a safe and effective method for local anesthesia during fiberoptic intubation.
  • This technique was preferred by both patients and performing endoscopists.
  • It offers advantages in terms of patient comfort and procedural efficiency.