Local anesthesia with blue-dyed lidocaine for a better patient’s tolerance during office-based laryngology procedures: how I do it

Background In-office laryngological procedures became common alternatives to general anesthesia for biopsies, injection laryngoplasties, and laser procedures. The limiting step remains the laryngeal anesthesia whose quality can influence patients’ and operators’ comfort. Methods We propose to dye the lidocaine with methylene blue and do an instillation through a catheter introduced in the video-endoscope’s operating channel, which permits a progressive anesthesia focused on the larynx, avoiding an unwanted pharyngeal anesthesia and any tracheal irritation. Conclusion Using blue-dyed lidocaine can help reduce the volume of anesthesia required for an office-based laryngology intervention, improving patients’ and surgeon’s comfort and reducing anesthesia’s side effects. Graphical Abstract