How long after topical anesthesia of the airway can a patient eat?

From the Guidelines

Patients should remain nil by mouth for at least 2 hours following airway topicalisation with lidocaine for awake tracheal intubation (ATI) to ensure the return of laryngeal reflexes and minimize the risk of aspiration. This recommendation is based on the Difficult Airway Society guidelines for ATI in adults, which suggest that the terminal elimination half-life of lidocaine is up to 2 hours 1. The duration of analgesic action of topical lidocaine can vary with concentration and method of administration, but the time to return of laryngeal reflexes can be longer 1.

Key considerations for determining when a patient can eat after topical anesthesia of the airway include:

• The type and concentration of topical anesthetic used
• The method of administration
• Individual patient factors, such as age and swallowing function
• The return of the gag reflex and ability to swallow saliva without difficulty

Healthcare providers should confirm that the patient's protective reflexes have returned before allowing oral intake, and patients should start with small sips of water before progressing to solid foods 1. If any signs of aspiration or swallowing difficulty occur, eating should be further delayed.

In clinical practice, it is essential to prioritize patient safety and take a cautious approach when determining the timing of oral intake after airway topicalization. The guidelines from the Difficult Airway Society provide a framework for managing patients undergoing ATI, and healthcare providers should follow these recommendations to minimize the risk of complications 1.

From the Research

Topical Anesthesia of the Airway

• The provided studies do not directly address how long after topical anesthesia of the airway a patient can eat 2, 3, 4, 5, 6.
• These studies focus on the safety and efficacy of different topical anesthetics, such as lidocaine and tetracaine, for procedures like bronchoscopy and intubation.
• They discuss the administration methods, dosages, and effects of these anesthetics on patients, but do not provide information on post-procedure eating guidelines.

Relevant Information

• Topical anesthesia of the airway is commonly used for awake intubation and bronchoscopy procedures 2, 3, 4, 5, 6.
• The choice of anesthetic and administration method can affect the patient's comfort and the procedure's success 3, 4, 5, 6.
• However, the provided studies do not mention specific guidelines for eating after topical anesthesia of the airway.

Lack of Direct Evidence

• Since the studies do not directly address the question of how long after topical anesthesia of the airway a patient can eat, it is not possible to provide a specific answer based on the available evidence 2, 3, 4, 5, 6.