2019 Volume 60 Issue 1 Pages 11-15
In clinical practice, laryngopharynx local anesthesia is a procedure used when performing biopsies, removing foreign bodies, etc. We have been conducting videoendoscopic laryngeal surgery under local anesthesia since 2003, and in such cases suppression of throat reflex and laryngeal reflex is important. To achieve this, it is necessary to properly deliver the anesthetic to the target site.
With local anesthesia, the amount to be administered is predetermined and its effective time is limited. For these reasons, in order to obtain stable effectiveness it is important to administer the anesthetic efficiently according to a set procedure. First, Xylocaine Viscous 2% should be administered to the laryngopharynx. Next, Xylocaine 4% should be sprayed progressively from the pharyngeal cavity to the laryngeal cavity, followed by a second application to the same area, this time using a cotton swab. As the anesthetic effectiveness of Xylocaine is said to weaken after about 20 minutes, the anesthesia process needs to be completed within 20 minutes.
At Fukushima Medical University, to date a total of 316 patients have undergone videoendoscopic laryngeal surgery under the local anesthesia method described above. Of these, 16 patients (5.1%) had surgery discontinued because throat reflex could not be suppressed or the reflex occurred during the surgery. These results indicate that the prescribed method is useful. Anesthesia performed by systematic procedure was deemed an important factor for successful videoendoscopic laryngeal surgery under local anesthesia.
