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Anesthesia mumps and morbid obesity

D Narang1, A Trikha, C Chandralekha

  • 1Dept. of Anaesthesiology and Intensive Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. sraiims@gmail.com

Acta Anaesthesiologica Belgica
|December 16, 2010
PubMed

Insights

Parotid gland swelling, a rare surgical complication, is linked to morbid obesity. This case highlights potential ischemic sialadenitis due to positioning in obese patients, emphasizing preventative measures.

Area of Science:

  • Anesthesiology
  • Surgical Complications
  • Obesity Medicine

Background:

  • Parotid gland swelling is a rare complication associated with general anesthesia across various patient demographics and surgical procedures.
  • This condition, while uncommon, necessitates awareness among healthcare providers for accurate diagnosis and management.
  • The association between morbid obesity and this complication has not been widely reported.

Observation:

  • A 45-year-old morbidly obese female (BMI 50.5 kgm-2) developed unilateral painful parotid gland swelling postoperatively.
  • The swelling occurred on the dependent side after surgery for a left humerus fracture, managed with the patient in a right lateral position.
  • Head positioning during surgery utilized a soft bandage head ring, a standard practice for such procedures.

Findings:

  • The case suggests a potential link between morbid obesity and parotid gland swelling post-surgery.
  • A proposed mechanism involves the unique cervical anatomy of morbidly obese patients, leading to vascular compression and compromised blood flow.
  • This compromised perfusion may result in ischemic sialadenitis, manifesting as parotid gland swelling.

Implications:

  • Physicians should consider parotid gland swelling as a potential complication in morbidly obese patients, especially after procedures requiring specific positioning.
  • Recommendations include minimizing neck manipulation and ensuring adequate facial padding during surgery.
  • Discouraging the use of head rings for head positioning in morbidly obese patients may help prevent this complication.

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