Parotid gland swelling that occurs during general anesthesia is called anesthesia mumps. Although most cases of anesthesia mumps reportedly occur during general anesthesia, there are some cases of anesthesia mumps occurring during intravenous sedation. The mechanism for anesthesia mumps has not yet been elucidated. However, according to previous reports, anesthesia mumps are caused by various factors such as the effects of anticholinergic drugs on the autonomic nervous system, mechanical pressure on the parotid gland, and intubation damage. We treated a case with bilateral parotid gland swelling after dental treatment under intravenous sedation with propofol.
The patient was a 39-year-old man (height, 180 cm ; weight, 75 kg) who was scheduled to undergo dental treatment under intravenous sedation because of a severe gag reflex. Intravenous sedation was performed using propofol. During the treatment, a large amount of saliva was secreted from the parotid papillae. However, no other problems occurred. After the completion of the dental treatment, the swelling of bilateral parotid glands was observed. We then consulted an oral surgeon, and he widened the bilateral orifice of the parotid papillae. A large amount of saliva was drained, and the swelling of the parotid gland was reduced somewhat. Axial magnetic resonance imaging performed on the first postoperative day (POD) showed bilateral parotid gland swelling and duct enlargement. However, no organic disorder in the parotid gland was observed. The parotid gland swelling disappeared on the twelfth POD.
The enhancement of salivary secretion in response to propofol may cause swelling of the parotid gland.
