Rajan Sunil, Puthenveettil Nitu, Paul Jerry
Department of Anesthesiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
J Anaesthesiol Clin Pharmacol. 2014 Apr;30(2):199-202. doi: 10.4103/0970-9185.130016.
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.
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.
Both group A and B were comparable with respect to patient immobility and hemodynamic stability. There was no intraoperative propofol requirement in group A.
Transtracheal block is a safe and successful alternative to propofol infusion during surgeries where muscle relaxants are to be avoided.
在全腮腺切除术中通常需要进行面神经监测，这使得长效肌肉松弛剂无法使用，丙泊酚输注仅用于确保患者不动。我们旨在比较经气管阻滞的全腮腺切除术中患者的术中不动、血流动力学稳定性和丙泊酚消耗量。
40例患者被分为两组，每组人数相等。术前，A组患者接受4ml 4%利多卡因的经气管阻滞，而B组患者未接受阻滞。如果患者出现移动、心动过速或高血压，A组患者静脉注射30mg丙泊酚并开始丙泊酚输注（100mg/小时）。在B组中，插管后不久即开始丙泊酚输注（100mg/小时）。
A组和B组在患者不动和血流动力学稳定性方面具有可比性。A组术中无需丙泊酚。
在需要避免使用肌肉松弛剂的手术中，经气管阻滞是丙泊酚输注的一种安全且成功的替代方法。
