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To the Editor: We would like to report a simple technique for topical anaesthesia of the airway. It obviates the need for complicated equipment, and is well tolerated by the patient. After administration of an antisialogogue, 8-10 ml of 4% lidocaine are drawn up into a 20 ml syringe, and then diluted by an equal volume of sterile water. Then the patient is asked to open his or her mouth, and extrude his or her tongue, which is grasped with a gauze pad. Very gentle traction is then applied, which prevents the patient from swallowing. Two to three ml of the solution is deposited at the back of the patient's tongue, and allowed to trickle backwards during deep breathing. This is repeated every 2-3 minutes. If mouth opening is limited, a 14 gauge cannula attached to the syringe facilitates the process. Fiberoptic bro',choscopy and tracheal intubation can proceeed tbrthwith. We have used this technique successfully is over 30 patients for anticipated difficult intubation, diagnostic bronchoscopy, and tracheal intubation in the presence of a fractured cervical spine.

Venous tolerance to etomidate in lipid emulsion or propylene glycol (hypnomidate)