Case report demonstrates effective nasal topicalization with lidocaine for awake intubation in difficult airways, suggesting improved outcomes.
Awake flexible bronchoscopic (FB)–guided nasotracheal intubation is often necessary for managing difficult airways, especially in maxillofacial surgeries. We present 2 cases used a novel device for airway topicalization with a local anesthetic (LA) solution. This device integrates a nasal trumpet with a nebulization chamber to deliver 4% lidocaine, effectively anesthetizing the nasal cavity, nasopharynx, and the vocal cords. This technique was successfully used in 2 patients, ensuring smooth and efficient awake FB-guided nasotracheal intubation while minimizing adverse effects such as epistaxis, coughing, or discomfort.
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Goswami et al. (2025) studied this question.
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