Case 49: A Case of Anisocoria Following General Anesthesia
A 12-year-old boy (American Society of Anesthesiologists physical status II [ASA 2]) (62 kg and 5′) is scheduled for a repair of a pectus excavatum (funnel chest). His preoperative laboratory values and chest X-ray are normal. After adequate sedation with oral midazolam (0.07 mg/kg), you take him to the operating room where an intravenous (IV) line is placed. Routine general anesthesia is induced using propofol, fentanyl, and vecuronium. The airway is secured and anesthesia maintenance is with N2O/O2 with sevoflurane. Another IV is placed together with a right radial arterial line. Attempts to cannulate the right internal jugular vein (IJV) prove difficult, as the ultrasound machine intermittently stops working. A new ultrasound machine is brought in and the IJV is successfully cannulated.
KeywordsIntensive Care Unit Operating Room Internal Jugular Vein Neurological Sign Pain Level