Education  |   January 2017
Anesthesia for Ophthalmic Artery Chemosurgery
Author Notes
  • From the Department of Anesthesiology (J.H.S., J.H.H.) and Department of Interventional Neuroradiology (Y.P.G.), New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York.
  • Submitted for publication April 15, 2016. Accepted for publication September 1, 2016.
    Submitted for publication April 15, 2016. Accepted for publication September 1, 2016.×
  • This article is featured in “This Month in Anesthesiology,” page 1A.
    This article is featured in “This Month in Anesthesiology,” page 1A.×
  • Figures 1 and 4 were enhanced by Annemarie B. Johnson, C.M.I., Medical Illustrator, Vivo Visuals, Winston-Salem, North Carolina.
    Figures 1 and 4 were enhanced by Annemarie B. Johnson, C.M.I., Medical Illustrator, Vivo Visuals, Winston-Salem, North Carolina.×
  • Address correspondence to Dr. Scharoun: Department of Anesthesiology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, 525 E 68 St (P-305), New York, New York 10065. jhs2001@med.cornell.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Education / Clinical Concepts and Commentary / Cardiovascular Anesthesia / Central and Peripheral Nervous Systems / Ophthalmologic Anesthesia / Pediatric Anesthesia / Respiratory System / Technology / Equipment / Monitoring
Education   |   January 2017
Anesthesia for Ophthalmic Artery Chemosurgery
Anesthesiology 1 2017, Vol.126, 165-172. doi:10.1097/ALN.0000000000001381
Anesthesiology 1 2017, Vol.126, 165-172. doi:10.1097/ALN.0000000000001381
A 2-YR-OLD boy with retinoblastoma is undergoing intra-arterial chemotherapy with general endotracheal anesthesia. His right femoral artery was cannulated, and a microcatheter was advanced toward the internal carotid artery (ICA). As the catheter tip nears the orifice of the ophthalmic artery (OA), the tidal volume abruptly drops 75%. No wheezing is heard, but albuterol is given, with little improvement, and the patient desaturates. After 3 min of hand ventilation, his tidal volumes improve, but he then becomes bradycardic and hypotensive. He ultimately requires several doses of epinephrine and intravenous volume expansion to stabilize his vital signs. At the conclusion of the procedure, he returns to baseline, is extubated, and has an unremarkable course in the recovery room.
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