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Case Report

Anaesthetic Management of a Patient with Parotid Abscess with Concomitant Organophosphorous Compound Poisoning

Sujatha MP , Preethi Rathnasabapathy1 , Sujatha MP2

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Indian Journal of Anesthesia and Analgesia 8(4):p 27-30, July-August 2021. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8421.65

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Preethi Rathnasabapathy, Sujatha MP/Anaesthetic Management of a Patient with Parotid Abscess with Concomitant Organophosphorous Compound Poisoning/Indian J Anesth Analg. 2021; 8(4): 445-447.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Introduction: Organophosphorous compounds are chemical agents in wide spread use throughout the world in agricultural industries. This poses a major challenge to an anesthesiologist; there is accumulation of acetylcholine causing overstimulation of muscarinic
and nicotinic receptors disruption of transmission of nerve impulses in both peripheral and central nervous system.

Case Report: A 47 year old male presented with alleged history of OP compound consumption with complaints of pain and swelling on the left cheek. On examination Diffuse swelling with warmth and tenderness was present. A diagnosis of parotid abscess was made.
Systemic examination - CNS - GCS-E4M5V4 with bilateral pupil -2mm reacting to light. Pseudo cholinesterase was 380.

Anaesthetic Management: Preloaded with 500ml RL. Monitors connected. Patient wason continuous Atropine infusion, Inj Midazolam and Inj fentanyl. Preoxygenated with 100% oxygen. Induced with Inj Propofol. Laryngeal mask airway(LMA) number 5- Proseal
was inserted. Anaesthesia maintained with 50% nitrous oxide in oxygen, IV propofol with intermittent positive pressure ventilation. Inj Atropine infusion was continued at 3ml/hr and titrated according to heart rate. The haemodynamic parameters remained stable throughout the procedure. The patient was extubated, Postoperative recovery was uneventful.

Conclusion: The use of muscle relaxants can produce bradycardia and prolong the motor recovery.Volatile anesthetics can also cause bradyarrythmias. In this case report we found that patient with OP compound consumption can safely be managed under general anaesthesia with IV propofol, without muscle relaxant and inhalational volatile anaesthetics.

 

 

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Cite this article

Preethi Rathnasabapathy, Sujatha MP/Anaesthetic Management of a Patient with Parotid Abscess with Concomitant Organophosphorous Compound Poisoning/Indian J Anesth Analg. 2021; 8(4): 445-447.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8421.65

Keywords

Organophosphorous; Parotid abscess

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