title: Total parotidectomy under local anesthesia: a novel technique.
abstract: Parotidectomy is a common procedure usually done for a parotid mass necessitating a histological diagnosis. Operation is normally performed under General anesthesia with a nerve stimulator to facilitate facial nerve stimulation. We describe a new technique with reports of three cases, making total parotidectomy under local anesthesia possible. The ascending cervical branch of cervical plexus and the auriculotemporal nerve were anesthetized by bupivacaine 0.25% (2mg/kg) and lignocaine with adrenaline 7 mg/kg. Effective onset of anesthesia was within 15-25 minutes and the operations lasted between 2-3 hours without any complications. This offers advantage in high-risk patients where general anesthesia is contraindicated. The facial nerve can be easily identified with on command movements by the patient rendering the use of nerve stimulator or injection of the dye superfluous. This technique makes total parotidectomy an outpatient procedure and facilitates an early discharge.
authors.affiliation: Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi. kamranshahid1712@yahoo.com
authors.forename: Kamran
authors.initials: K
authors.lastname: Shahid
authors.forename: Bilal Karim
authors.initials: BK
authors.lastname: Siddiqui
authors.forename: Muhammad Hammad
authors.initials: MH
authors.lastname: Tahir
authors.lastname: Salman bin Ayub
authors.forename: Ghulam Murtaza
authors.initials: GM
authors.lastname: Memon
authors.forename: Adnan
authors.initials: A
authors.lastname: Yousuf
authors.forename: Arif
authors.initials: A
authors.lastname: Hussain
authors.lastname: Osmani
authors.forename: Abdul Karim
authors.initials: AK
authors.lastname: Siddiqui
mesh_terms: D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D002045:Bupivacaine; D002572:Cervical Plexus; D004837:Epinephrine; D005260:Female; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000601:surgery*; D010306:Parotid Gland / Q000473:pathology / Q000601:surgery*; D010865:Pilot Projects
chemical_list: D008012:Lidocaine; D002045:Bupivacaine; D004837:Epinephrine