A complication after percutaneous nephrolithotomy: Anesthesia mumps

Abstract

Some surgical procedures performed under moderate and sometimes extreme positions expose patients to nonphysiological changes. Especially, the manipulations of a patient in prone and lateral decubitus position might increase complications. Anesthesia mumps has been reported as one of these complications. It has been found to be rare but known entity associated with patients of all age groups and all surgical positions. We herein describe an early noticed acute case of unilateral anesthesia mumps that developed after endotracheal intubation in prone position in a 54-year-old female. Anesthesia mumps may occur in the immediate postoperative period with no suspicious predisposing factor. The reports of such cases would increase the awareness among anesthesiologists and postoperative caregivers regarding this benign complication.

A Case of Bilateral Anesthesia Mumps After General Anesthesia for Tibial Fracture Surgery

“…The precise mechanism of anesthesia mumps is still unclear, but diverse mechanisms have been hypothesized. Retrograde passage of air into the parotid gland along the Stensen's duct and occlusion of this duct due to retention of secretions are two major theories for this complication (10)(11). Accordingly, trauma, straining and or coughing during intubation and extubation; vasodilation and hyperemia in the parotid glands; perioperative use of drugs like atropine, succinylcholine and muscle relaxants, venous engorgement of the head and neck; dehydration; and mechanical blockage of the parotid duct by intubation and fixation of the ETT are some of the suggested mechanisms (8,12,13).…”

Acute transient sialadenitis – “anesthesia mumps:” Case report and review of literature

“…[ 11 ] It is usually transitory and resolves spontaneously without any treatment. [ 12 ] However, there are few case reports where it has led to airway obstruction that required reintubation or tracheostomy. [ 3 4 13 ]…”

Anaesthesia mumps: much to do about nothing

“…Several authors have postulated contributory causes such as straining or coughing during anaesthesia leading to retrograde airflow through Stensen’s duct,10 long-duration surgery,2 head positioning in the prone, lateral or sitting position,2 10–12 use of perioperative drugs such as atropine, succinylcholine, glycopyrrolate, benzodiazepines or morphine, preoperative or perioperative dehydration, and other conditions precipitating obstruction or hyposecretion of the salivary ducts 2 7 10–12. The literature also suggests that increased body habitus,6 malnutrition, bulimia/anorexia, alcoholism, Sjogren’s syndrome, HIV (and other immunosuppressive states), sialolithiasis, ductal stenosis and perioral trauma can contribute to patient susceptibility to anaesthesia mumps 8.…”

“…The literature also suggests that increased body habitus,6 malnutrition, bulimia/anorexia, alcoholism, Sjogren’s syndrome, HIV (and other immunosuppressive states), sialolithiasis, ductal stenosis and perioral trauma can contribute to patient susceptibility to anaesthesia mumps 8. To exclude infectious aetiologies, serum amylase measurement and blood cell count can differentiate viral or bacterial parotitis or other allergic causes 12…”

“…While the slight head down lithotomy position was conducive to our procedure, it can contribute to venous pooling and perioral congestion precipitating anaesthesia mumps. Likewise, other shorter surgical procedures ranging from 30 to 85 min still reported this complication, potentially attributable to a combination of patient manoeuvring and distinctive drug effects on the parotid gland: use of glycopyrrolate to reverse muscle relaxation,8 9 lithotomy position with steep Trendelenberg,8 supine positioning with atropine administration,6 prone positioning with atropine administration,12 premedication and reversal with glycopyrrolate coupled with succinylcholine anaesthesia induction and supine positioning 11. Thus, it is important that surgeon and anaesthetist give consideration to appropriate surgical position and perioperative medications.…”