In Reply:-Drs. Burton and Zornow have provided a cost-effective method to institute tracheal anesthesia to the intubated patient, thus facilitating a smooth nonstimulating extubation. This method should provide an alternative to “deep extubation” in appropriate surgical candidates and will probably allow more rapid emergence and extubation with fewer respiratory problems. The suggested methodology may facilitate emergence from intubation to compare with the minimal stimulation found with the use of the laryngeal mask airway, and a comparative study would be welcomed. Optimal timing of lidocaine administration may be paramount, as in my experience, tracheal anesthesia typically lasts only 15 to possibly 20 min, although definitive studies of this aspect remain unknown to me.

Paul M. Kempen, M.D., Ph.D.

7707 Northwest Stonegate Place; Lawton, Oklahoma 73505

(Accepted for publication April 26, 1997.)