%0 Journal Article
%A Ankita Kaasat
%A Sakshi Thakore
%A Pratibha Yadav
%A Nirdesh Thakore
%T Balancing sedation and responsiveness with dexmedetomidine–ketamine in pediatric marcus gunn jaw-winking syndrome: A case report
%J Journal of Scientific Innovations in Anesthesiology
%D 2026
%V 1
%N 3
%P 95-99
%R 10.65929/JSIA.2026.1.3.007
%X 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.
%U https://jsiajournal.org/volume/1/issue/3/article/balancing-sedation-and-responsiveness-with-dexmedetomidine-ketamine-in-pediatric-marcus-gunn-jaw-winking-syndrome-a-cas