General anaesthetics/atracurium besilate
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General anaesthetics/atracurium besilate Anaesthesia mumps: case report
A 52-year-old man developed anaesthesia pumps following treatment with atracurium besilate, fentanyl, isoflurane, thiopental sodium and nitrous oxide for induction of anaesthesia, maintenance of anaesthesia and as muscle relaxant therapy [routes not stated; not all dosages stated]. The man, who had right tibial fracture after a motor accident, was hospitalised and scheduled for a open reduction and internal fixation surgery. After arriving in the operational room, an IV access was established. Following pre-oxygenation, he was administered fentanyl 200µg, atracurium [atracurium besilate] 40mg and thiopental sodium [thiopental Na] 400mg for induction of anaesthesia and muscle relaxation. Thereafter, he was intubated and ET tube was fixed on the right side of the mouth. Following intubation, he was administered 50% oxygen and nitrous oxide [N2O] along with isoflurane 1 MAC for maintenance of anaesthesia. He also received morphine, midazolam and unspecified crystalloids during the surgery. However, 30 minutes after the initiation of surgery, he developed swelling of both parotid regions. Apart from this, the surgery was uneventful and lasted for 2.5 hours. Thereafter, he was administered neostigmine and atropine. He was extubated. In the recovery unit, moderate swelling of both parotids was noted. The swelling expanded down to the mandibular angle with no complaint of pain, difficulty in swallowing, and dyspnoea. Clinical examination revealed diffused oedema over the parotid glands. In the intraoral examination, the orifice of the Stensen’s duct was open. There were no signs of local inflammation or infection. He was diagnosed with anaesthesia mumps secondary to fentanyl, isoflurane, thiopental sodium and nitrous oxide. Muscle relaxant therapy with atracurium besilate was also considered have contributed in the development of anaesthesia mumps. The man was treated with unspecified non-steroidal anti-inflammatory drugs. After five days, the swelling decreased. Within seven days, the anaesthesia pumps completely resolved. Etemadi-Aleagha A, et al. A case of bilateral anesthesia mumps after general anesthesia for tibial fracture surgery. Acta Medica Iranica 58: 240-242, No. 5, Jan 2020. Available from: URL: https://publish.kne-publishing.com/index.php/ACTA/article/view/3958
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Reactions 14 Nov 2020 No. 1830
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