Smooth Extubation with Bupivicaine

I've always used topical lidocaine to spray the above and below the vocal cords in cases less than 2 hours to try to have a smoother extubation. In longer cases, I have run low-dose remifentanil infusions on wakeup for cases such as neuroanesthesia, carotids, certain ENT cases, etc. One of my colleagues was taught to use bupivicaine 0.25% and spray about 3-5 mL using a flexible LMA Madgic atomizer. I've tried it out and it seems... Smooth Extubation with Bupivicaine
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Anesthesiology Source Type: forums