Anaesthesia mumps
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Transcript of Anaesthesia mumps
Prof. Mridul M. Panditrao
Consultant Department of Anesthesiology and
Critical care Rand memorial hospital
Freeport Bahamas
ANAESTHESIA MUMPS
ANAESTHESIA MUMPS
Reilly in 1971
Benign self limiting enlargement of parotid glands appearing after general anaesthesia
Relatively unknown & an under documented condition
Our Experience
21 cases of Anaesthesia mumps Out of 1707 cases operated GA for
various causes during the course of one year
Incidence of Anaesthesia mumps 12.3 per thousand
Age range 18 – 65 yrs M/F ratio 1:1
3 Prototype cases
3 prototype cases were chosen due to the difference in the nature and methodology of GA administered
Thorough preanaesthetic checkup done
No parotid gland swelling preoperatively
Case - 1
64 y/o male posted for wide local excision of keratinizing squamous intra epithelial neoplasia of buccal mucosa
Premedication Inj Atropine 0.6mg, Inj Midazolam 1mg,
Inj Butorphanol 1mg IV
Induction Inj Thiopentone 350mg, Inj
Succinylcholine 100mg IV
Case - 1
Intubation Nasally with 7.5 RAE tube north pole after D/L
scopy Oral packing done
Maintenance IPPV with O2, N2O & Isoflurane Non depolarizing muscle relaxant: Inj
Vecuronium IV
Position Supine, head turned to left
Case - 1
Duration of surgery 120 min
Reversal Inj Neostigmine 2.5mg, Inj Atropine
1.2mg IV Pack removal & Extubation
Bilateral parotid swelling observed 2 min after extubation
Swelling resolved after 4 days
Case - 2
60 y/o male posted for electroconvulsive therapy for schizophrenia
Premedication Inj Glycopyrrolate 0.2 mg IV
Induction Inj Thiopentone 250mg, Inj
Succinylcholine 75 mg IV
Case - 2
Mask ventilation IPPV with 100% O2 Duration 15 min
Position Supine
Bilateral parotid gland swelling appeared on regaining spontaneous ventilation
Swelling resolved after 3 days
Case - 3
30 y/o female posted for MRM
Premedication Inj Glycopyrrolate 0.2 mg, Inj
Midazolam 1mg, Inj Butorphanol 1mg IV
Induction Inj Thiopentone 300mg, Inj Rocuronium
35 mg IV
Case - 3
Intubation Orally with 7.5 ETT after D/L scopy
Maintenance IPPV with O2, N2O & Isoflurane
Duration of surgery 180 min
Position Supine
Case - 3
Reversal Inj Neostigmine 2.5mg, Inj Atropine
1.2mg IV Patient extubated
Bilateral parotid gland swelling was observed on table immediately after extubation
Swelling resolved after 4 days
3 Prototype cases
Local Examination
B/L Swelling of parotid gland
Size: 4 3 1.5 cm
Diffuse, non tender, freely mobile
No change in colour or
temperature
Non Anaesthetic Causes of Parotid Enlargement
Glandular inflammation Infection Allergic reaction Ductal outlet obstruction Stones Tumor Trauma Antihistamines Diuretics Dehydration
Anaesthetic Causes of Parotid Enlargement
Benzodiazepines Ketamine Neuro Muscular Blocking Drugs Anaesthetic gases & Unhumidified O2 Increased salivary secretions Decreased salivary outflow
Pneumoparotiditis due to Intraoral pressure: In glass blowers: During mask ventilation
ANAESTHESIA MUMPS
Probable causes Fluid stasis Ductal spasm
Clinical course
Spontaneous resolution of the swelling within 3 – 5 days
No respiratory distress or obstruction
Conclusion
Benign Relatively unknown Not so uncommon Self Resolving Condition which rarely leads to any
complications.
No Specific treatment needed Simple assurance