Replace the 25 gauge needle with a 22 gauge needle on the lidocaine syringe. Position the needle as previously: parallel to the bed and aiming towards the umbilicus. Insert the needle into the deeper tissues of the back while injecting lidocaine. Remember to apply suction to the needle prior to injection to prevent intravascular injections. As you get deeper, you may provide a vertical "fan" shape area of injection to help anesthetize the recurrent spinal nerves. Withdraw the needle as you are finishing, injecting lidocaine on the way out.