How does local anesthetic airway topicalisation, for awake fiberbreoptic intubation (AFOI), affect patient reaction time?

Awake fibreoptic intubation (AFOI) is the method of choice for intubation and securing of a potentially difficult airway. Routine practice worldwide involves ‘topicalisation’ (numbing) of the airway with Local Anaesthetic (LA) to enable a fiber optic camera to be advanced through the airway and into the trachea, usually with the patient awake and under no sedative influence. Currently there are no data on the effects of the LA used this way on cognitive or motor function, and patients are allowed to return home shortly after such a procedure. There is no advice given with regards to driving or operating heavy machinery despite anesthetists who have had this procedure describing ‘funny feelings’ following administration of topical LA and multiple studies that report subjective feeelings of dizzines, tingling, euphoria and dysphoria We wish to assess the impact of LA on reaction time (and hence both neural and motor function) following volunteer participation in an AFOI Course that we run half yearly for anesthetists