Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia

Acute swelling of the parotid gland after general anesthesia [commonly known as anesthesia mumps or acute postoperative sialadenitis] is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy

comparison of intra cuff pressures in high-flow and low-flow nitrous oxide anesthesia

To investigate intra cuff pressure changes in low-flow anesthesia [LFA] and high-flow [HFA] N2O anesthesia during moderate-duration surgical procedures. We carried out this prospective, randomized, single blind study at Numune Educational and Research Hospital, Ankara, Turkey between January to December 2005. Seventy patients aged between 18-65 years, American Society of Anesthesiologists [ASA] physical status grades I-III, undergoing elective surgery were enrolled in this study. Following a standardized induction, anesthesia was maintained with isoflurane [end-tidal 0.9-1%] at 4 L/minute for the HFA group, or 1 L/minute for the LFA group fresh gas flows. Endotracheal tube cuff [intra cuff] pressures were measured continuously with a pressure manometer, and inspired oxygen and N2O levels were noted every 10 minutes throughout the study. There was no significant difference between HFA and LFA groups for initial [first] cuff pressures [mean +/- SD, HFA=20.9 +/- 4.19, LFA=20.4 +/- 4.11, cmH2O], and maximum cuff pressures [MCP] [mean +/- SD, HFA=32.3 +/- 18.74, LFA=33.5 +/- 8.89, cmH2O] [p > 0.05]. The time to reach the maximum intra cuff pressure was significantly shorter in the LFA group [77.4 +/- 20.33 minutes], than the HFA group [89.3 +/- 23.94 minutes], [p=0.038]. Between the tenth and nineteenth minutes, inspired oxygen level was significantly higher in the HFA group [p=0.001], whereas inspired N2O was significantly higher in the LFA group [p=0.001]. The intra cuff pressures should be monitored carefully during LFA, since the duration to reach the maximum intra cuff pressures was shorter than that of HFA