Topical airway anesthesia devices

Here we list (some of the) devices available for topically anesthetizing the airway which we use at UCSF:

Mucosal atomizer


Tha nasal atomizer has a cone-shaped foam plug with which the device is placed into the nostril. While the oral atomizer is malleable it is still relatively rigid and it is not recommended to place this device into the nasal passage or past the vocal chords into the trachea.


The nasal atomizer is useful for delivering local anesthetic and/ or nasal decongestant to the nasal passage in preparation for awake and asleep fiberoptic nasal intubation, or for nasendoscopy as part of a (preoperative) airway assessment.

The oral atomizer is used for delivering local anesthetic to the oro- and hypopharynx as well as the larynx in preparation for awake and asleep fiberoptic nasal or oral intubation, or to just anesthetize the larynx if intubation under general anesthesia without muscle relaxation is desired.

Laryngotracheal Topical Anesthesia kit (LTA)



The kit consists of a prefilled syringe containing 4ml of 4% Lidocaine and the actual injector device. After removing the grey rubber cap from the syringe and the yellow plastic cap from the injector device the two parts have to be screwed together.

The LTA is designed to be advanced past the vocal chords into the trachea no further than the black mark. The device has a closed rounded tip and twelve side-holes proximally through which the Lidocaine is delivered more or less circumferentially into the airway.

Despite its atraumatic tip the device is fairly rigid, not malleable and will break if you try to bend it into a different shape.


This device is meant to to be placed into the airway under direct vision, i.e. during direct laryngoscopy. It is not well-suited to be used in conjunction with a videolaryngoscope since the shape of the injector cannot be adapted. The oral mucosal atomizer is a better choice in that instance.