Local anesthesia with blue-dyed lidocaine for a better patient's tolerance during office-based laryngology procedures: how I do it
Related Experiment Video
Updated: Jul 21, 2025

CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Ralph Haddad1, Alexia Mattei2, Antoine Giovanni2
1Department of Oto-Rhino-Laryngology and Head and Neck Surgery, AP-HM, La Conception University Hospital, Aix-Marseille University, 147 Boulevard Baille, 13385 CEDEX 5, Marseille, France. ralph.haddad@ap-hm.fr.
Background:
In-office laryngological procedures became common alternatives to general anesthesia for biopsies, injection laryngoplasties, and laser procedures. The limiting step remains the laryngeal anesthesia whose quality can influence patients' and operators' comfort.
Methods:
We propose to dye the lidocaine with methylene blue and do an instillation through a catheter introduced in the video-endoscope's operating channel, which permits a progressive anesthesia focused on the larynx, avoiding an unwanted pharyngeal anesthesia and any tracheal irritation.
Conclusion:
Using blue-dyed lidocaine can help reduce the volume of anesthesia required for an office-based laryngology intervention, improving patients' and surgeon's comfort and reducing anesthesia's side effects.
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