JSIA ISSN 3139-3608
Case Report Open access

Balancing sedation and responsiveness with dexmedetomidine–ketamine in pediatric marcus gunn jaw-winking syndrome: A case report

Ankita Kaasat Author Dept. of Anesthesia Ananta Institute of Medical Science and Research Centre Tantela, Rajasthan, India 0000-0001-7959-067X , Sakshi Thakore Corresponding author drsakshiarora88@gmail.com Dept. of Anesthesia Ananta Institute of Medical Science and Research Centre Tantela, Rajasthan, India 0000-0003-2295-9135 , Pratibha Yadav Author Dept. of Anesthesia Ananta Institute of Medical Science and Research Centre Tantela, Rajasthan, India 0000-0002-9107-9169 , Nirdesh Thakore Author Dept. of Anesthesia Ananta Institute of Medical Science and Research Centre Tantela, Rajasthan, India 0000-0001-9847-4340

  1. 1 Dept. of Anesthesia, Ananta Institute of Medical Science and Research Centre, Tantela, Rajasthan, India
Pages 95-99 Published 2 November 2026 DOI 10.65929/JSIA.2026.1.3.007 Rights held by the authors
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Abstract

Marcus Gunn Jaw Winking Syndrome (MGJWS) is a rare congenital condition characterized by unilateral ptosis associated with synkinetic elevation of the upper eyelid during jaw movements. Patients with moderate-to-severe MGJWS often require surgical correction for cosmetic improvement and relief of visual axis obstruction. Intraoperative assessment of eyelid symmetry necessitates intermittent patient arousal, which poses a significant anesthetic challenge in pediatric patients. Additional anesthetic considerations include maintaining child cooperation, alleviating anxiety, ensuring airway safety, providing adequate analgesia and optimal sedation and the risk of the oculocardiac reflex. There is a paucity of literature regarding anesthetic management in pediatric patients with MGJWS necessitating intermittent arousal. We describe the successful anesthetic management of a child undergoing ptosis correction with sling suspension using procedural sedation with dexmedetomidine and ketamine combined with a supraorbital nerve block. This technique enabled repeated, smooth awakening, effective analgesia, stable cardiorespiratory parameters, satisfactory patient cooperation, and high surgeon satisfaction.

Dates & metrics

Received
15 Jun 2026
Accepted
22 Aug 2026
Published
2 Nov 2026
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4 downloads

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Keywords: Dexmedetomidine Ketamine Marcus Gunn phenomenon Nerve block Pediatrics

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How to cite this article

Kaasat A, Thakore S, Yadav P, Thakore N. Balancing sedation and responsiveness with dexmedetomidine–ketamine in pediatric marcus gunn jaw-winking syndrome: A case report. J. Sci. Innov. Anesthesiol. 2026;1(3):95-99. doi:10.65929/JSIA.2026.1.3.007

RIS BibTeX EndNote

Kaasat, A., Thakore, S., Yadav, P., & Thakore, N. (2026). Balancing sedation and responsiveness with dexmedetomidine–ketamine in pediatric marcus gunn jaw-winking syndrome: A case report. Journal of Scientific Innovations in Anesthesiology, 1(3), 95-99. https://doi.org/10.65929/JSIA.2026.1.3.007

RIS BibTeX EndNote

Ankita Kaasat, Sakshi Thakore, Pratibha Yadav, and Nirdesh Thakore. "Balancing sedation and responsiveness with dexmedetomidine–ketamine in pediatric marcus gunn jaw-winking syndrome: A case report." Journal of Scientific Innovations in Anesthesiology, vol. 1, no. 3, 2026, pp. 95-99. https://doi.org/10.65929/JSIA.2026.1.3.007

RIS BibTeX EndNote

Ankita Kaasat, Sakshi Thakore, Pratibha Yadav, and Nirdesh Thakore. "Balancing sedation and responsiveness with dexmedetomidine–ketamine in pediatric marcus gunn jaw-winking syndrome: A case report." Journal of Scientific Innovations in Anesthesiology 1, no. 3 (2026): 95-99. https://doi.org/10.65929/JSIA.2026.1.3.007

RIS BibTeX EndNote

Kaasat, A., Thakore, S., Yadav, P., and Thakore, N. (2026) 'Balancing sedation and responsiveness with dexmedetomidine–ketamine in pediatric marcus gunn jaw-winking syndrome: A case report', Journal of Scientific Innovations in Anesthesiology, 1(3), pp. 95-99. https://doi.org/10.65929/JSIA.2026.1.3.007

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© 2026 the authors. Published by REVO Publication. This article is distributed under CC BY 4.0, which permits use and redistribution provided the original work is properly cited.