We read the recent article of Woodruff et al. [1] with interest. A major advantage of the atomisation with lidocaine used in this study is the rapidity with which the airway can be anaesthetised, but this is achieved at the expense of administration of a large dose over a short time (about 5 min). We have concerns over the safety of this topi-calisation method in general clinical practice, particularly when the drug is rapidly administered to non-obese patients.
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