title: Transtracheal lidocaine: An alternative to intraoperative propofol infusion when muscle relaxants are not used.
abstract: BACKGROUND
  Facial nerve monitoring, often required during total parotidectomy, precludes use of long acting muscle relaxants and propofol infusion is used solely to ensure patient immobility. We aimed to compare intraoperative patient immobility, hemodynamic stability and propofol consumption during total parotidectomy following a transtracheal block.
  
  
  METHODS
  Forty patients were allocated to 2 equal groups. Preoperatively, group A patients received transtracheal block with 4 ml of 4% lidocaine, while no block was given to patients in group B. If there was patient movement, tachycardia or hypertension, group A patients received a bolus of propofol 30 mg and propofol infusion was started (100mg/hr). In group B, propofol infusion was started (100mg/hr) soon after intubation.
  
  
  RESULTS
  Both group A and B were comparable with respect to patient immobility and hemodynamic stability. There was no intraoperative propofol requirement in group A.
  
  
  CONCLUSIONS
  Transtracheal block is a safe and successful alternative to propofol infusion during surgeries where muscle relaxants are to be avoided.
authors.affiliation: Department of Anesthesiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Rajan
authors.affiliation: Department of Anesthesiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
authors.forename: Nitu
authors.initials: N
authors.lastname: Puthenveettil
authors.affiliation: Department of Anesthesiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
authors.forename: Jerry
authors.initials: J
authors.lastname: Paul
keywords: Nerve stimulation; parotidectomy; patient immobility; propofol infusion; transtracheal block