Overcoming Challenges: A Case Report of Dexmedetomidine-Ketamine Sedation and Peribulbar Block for Pediatric Ocular Surgery with Difficult Airway Predictors

Abstract

Children usually require general anesthesia when undergoing ophthalmic surgery since they are unable to cooperate and remain motionless during the procedure. Although most cases are straightforward, a subset of patients may have genetic syndromes or metabolic diseases associated with difficult intubation. A 10-year-old boy with an undiagnosed neurological condition and multiple predictors of difficult airway was scheduled for a cataract surgery. The preoperative evaluation showed a history of unsuccessful intubation attempts. Therefore, we decided not to induce general anesthesia and provide a sedation with dexmedetomidine and ketamine combined with a peribulbar block. Our positive experience demonstrates that there may be safe alternatives to general anesthesia for pediatric ophthalmic surgery, particularly when securing a definitive airway poses significant challenges.