A MODIFIED LARYNGEAL SPRAY

Abstract

THERE is a large number of different laryngeal sprays available, and the excuse for adding to this list is that the sprays I am now using are more satisfactory than others I have tried. Nebulizers which are complicated in design, and contain metal capillary tubes, suffer from the defect that unless they are washed clean after each occasional use— a costly matter, and troublesome—they soon become attacked by the alkaloid used as analgesic. Crystals deposit, and when the spray is taken off the shelf for use in a hurry it either blows nothing but air or delivers large and dangerous drops into the pharynx. The Rogers all-glass spray does not react in any way with the analgesic solution. It can be placed on the shelf after use and taken down again weeks later, and will immediately deliver a fine spray with no large drops. This spray, moreover, extends for about a yard from the nozzle, and can easily be operated with one hand. There is therefore no need to thrust any part of the spray into the pharynx, a procedure which is all too often the cause of movement of the laryngoscope and the elicitation of unsuppressed pharyngeal reflexes. The angle of the nozzle on the stem o the Rogers spray is about 120°. It is possible that when it is used with the patient supine, with the laryngoscope in position for direct spraying of the cords, the reservoir may be higher than the nozzle, and fluid may run down into the pharynx. Messrs. Thackray of Leeds have kindly made for me some sprays with an angle of 90°. These sprays do not deliver liquid analgesic drops in any of the positions in which they are likely to be used in normal practice.