Prof Mridul Panditrao, explains, about a known but relatively uncommon entity, followingGeneral Anesthesia. It is a diffuse swelling of Parotid glands bilaterally, so appears like the Mumps. As it follows GA, it is coloquially named as Anesthesia Mumps

1. Prof. Mridul M. Panditrao
 Consultant
 Department of Anesthesiology and Critical
care
 Rand memorial hospital
 Freeport
 Bahamas

2. ANAESTHESIA MUMPS

3. ANAESTHESIA MUMPS
 Reilly in 1971
 Benign self limiting enlargement of parotid
glands appearing after general anaesthesia
 Relatively unknown & an under documented
condition

4. 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

5. 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

6. 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

7. 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

8. 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

10. 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

11. 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

14. 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

15. 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

16. 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

18. 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

19. Non Anaesthetic Causes of
Parotid Enlargement
 Glandular inflammation
 Infection
 Allergic reaction
 Ductal outlet obstruction
 Stones
 Tumor
 Trauma
 Antihistamines
 Diuretics
 Dehydration

20. 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

21. ANAESTHESIA MUMPS
Probable causes
 Fluid stasis
 Ductal spasm
Clinical course
 Spontaneous resolution of the swelling within
3 – 5 days
 No respiratory distress or obstruction

22. Conclusion
 Benign
 Relatively unknown
 Not so uncommon
 Self Resolving
Condition which rarely leads to any
complications.
 No Specific treatment needed
 Simple assurance