An unusual complication with xylocaine spray in microlaryngeal surgery

Abstract

Topical lidocaine spray is commonly used to anaesthetise vocal cords and supraglottic structures, and to blunt the intubation and extubation responses. Application of local anaesthetic reduces the sympathetic response that occurs as a result of the stimulation of the larynx. Complications with this technique are rare. We encountered an unusual and unforeseen complication whilst using lidocaine spray in the airway of a patient undergoing microlaryngeal surgery (MLS) for a right vocal cord nodule.