“…the patient complained of excruciating pain in the left eye to the point she could not open it.”
Patient: middle-aged female, 5-feet tall, 65kg
Presenting diagnosis: retroperitoneal mass, s/p chemo
Planned procedure: excision of mass
Past medical history: diabetes mellitus, am FBS 127
Medications: metformin, naproxen
Anesthetic plan: general anesthesia, ETT
A middle-aged female patient presented for excision of a retroperitoneal mass s/p chemotherapy. She had a class 1 Mallampati score, mouth opening of greater than 3 finger breadths, thyromental distance >5 cm and good neck flexion/extension. Her cardiac and respiratory exams were within normal limits.
The patient was taken to the operating room after administration of midazolam 2 mg and pre-operative antibiotics were started. She was assisted to the OR table. An arterial line and central line were placed prior to induction with propofol, fentanyl, lidocaine, and succinylcholine. The patient’s eyes were taped shut with clear tape prior to laryngoscopy. Direct visual laryngoscopy with a Miller 2 blade revealed a grade 1 view of the vocal cords, and the provider successfully placed a 7.0 endotracheal tube (ETT) on the first attempt. The patient was placed in the left lateral position and the surgery proceeded. The case was uneventful with an estimated blood loss of approximately 500mL.
In the post-anesthesia care unit, the patient complained of excruciating pain in the left eye to the point she could not open it. A significant about of tearing was noted. The patient was quickly diagnosed with a corneal abrasion by an ophthalmologist. The patient was treated with antibiotic and NSAID eye drops and was ordered to wear an eye patch.