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Updated: Jun 9, 2026

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
05:43

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

Published on: January 13, 2017

Plasma lignocaine concentrations following topical laryngeal application

R L Eyres, W Bishop, R C Oppenheim

    Anaesthesia and Intensive Care
    |February 1, 1983
    PubMed

    Insights

    Laryngeal lignocaine spray in children is generally safe, but occasional high plasma concentrations were observed. Monitoring is advised, especially with simultaneous arterial and venous sampling showing early differences.

    Area of Science:

    • Pediatric Anesthesiology
    • Pharmacokinetics
    • Laryngeal Topical Anesthesia

    Background:

    • Topical lignocaine is used for laryngeal procedures in children.
    • Understanding plasma concentrations is crucial for safety.

    Purpose of the Study:

    • To measure plasma lignocaine concentrations after laryngeal spray in pediatric patients.
    • To assess the safety and variability of lignocaine absorption in children.

    Main Methods:

    • 96 children (2 weeks to 12 years) received lignocaine 4% spray to the larynx and subglottic area.
    • Plasma lignocaine concentrations were measured.
    • Simultaneous arterial and venous blood sampling was performed in some cases.

    Main Results:

    • Most plasma lignocaine concentrations were within the safe range (<4.5 µg/ml).
    • Occasional concentrations exceeded 8 µg/ml across all age groups.
    • A small but significant difference was noted between arterial and venous samples within 10 minutes.

    Conclusions:

    • Laryngeal lignocaine spray is generally safe for pediatric patients.
    • Vigilance for occasional high plasma concentrations is recommended.
    • Early pharmacokinetic differences may exist between arterial and venous blood.

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