Lidocaine spray may reduce muscle relaxant need during ERCP

This study tests if using a lidocaine spray in the throat, combined with a lower dose of muscle relaxant, can make inserting a breathing tube easier and safer during ERCP (a procedure to examine the bile ducts). The goal is to reduce the amount of muscle relaxant needed while still achieving good intubation conditions. 188 adults with liver problems scheduled for ERCP will be randomly assigned to receive either the lidocaine spray with low-dose muscle relaxant or the standard dose of muscle relaxant alone.