To the Editor:--We administered 2% lidocaine jelly (Figure 1) with a 10-ml syringe attached to a 4–5-inch long plastic suction catheter to the base of the tongue and pharynx of the patient. A total of up to 10 ml 2% lidocaine jelly is squirted on the tonsillar pillar area on each side. Administration of the topical anesthetic on the laryngeal side of the epiglottis and the larynx is avoided to preserve protective reflexes of the superior laryngeal nerve. The jelly, as opposed to solutions, adheres to the mucosal surfaces more effectively with quicker penetration. We see an almost immediate effect with the patients after application, allowing us to perform direct laryngoscopy and tracheal intubation smoothly.
Ivan Hronek, MD, Resident
Deepak Gupta, MD, Chief Resident, Department of Anesthesia
Young K. Choi, MD, F.A.C.P.M., Director, New Jersey Pain Institute, Assistant Professor, Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6100, New Brunswick, New Jersey 08901–1977