Advice for veterinary practices during the current shortage of Intubeaze®
Desensitisation of the arytenoids in cats is an important step prior to tracheal intubation or placement of a supraglottic airway device (v-gel®). Due to the current manufacturing issue with proprietary lidocaine spray (Intubeaze®), an alternative must be used. Our anaesthetists advise using adrenaline-free, 1% or 2% generic lidocaine solution for injection. Each spray of Intubeaze® delivers approximately 2 – 4 mg of lidocaine, equating to 0.1 – 0.2 ml of 2% lidocaine injection (0.2 – 0.4 ml of 1% lidocaine injection). Lidocaine should be drawn into a syringe and sprayed directly on the larynx (using direct laryngoscopy) using a flattened and shortened rigid dog urinary catheter to attempt to create a fine spray. Toxic doses of lidocaine reported in cats are 2 – 4 mg/kg. A normal adult cat will only require around 0.2 ml of 2% lidocaine to fully desensitise the larynx. Care should be taken in very small cats and kittens and the volume should be reduced to avoid toxicity. Note that any remaining lidocaine should be discarded in pharmaceutical waste and a new vial used for each patient as it does not contain a preservative. Also note that this formulation is unlicensed and used via the Cascade.
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