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May 24, 1965

Anesthesia of the Larynx in the Patient With a Full Stomach

JAMA. 1965;192(8):705-706. doi:10.1001/jama.1965.03080210049011

In the past decade a number of communications have been written concerning the danger of aspiration during the induction of general anesthesia in patients with full stomachs.1-7 A review of the many techniques recommended to avoid this complication has been published recently by Weaver.7 One of the frequently proposed safety measures is the insertion of a cuffed endotracheal tube prior to the induction of anesthesia. Although intubation performed with the patient awake certainly is one of the more reliable methods of avoiding aspiration, exception must be taken to the technique usually described for inserting the tube. It has been suggested that topical anesthesia of the larynx and trachea be performed to facilitate intubation of the adult patient. Though anesthesiologists differ as to whether percutaneous,7,8 transoral,1 or superior laryngeal block5 should be used, they nevertheless agree that surface anesthesia of the laryngeal and tracheal mucosa is

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