Disconjugate gaze

[coffeebythelake]

Healthy pt, no neurologic or ocular issues,
On emergence from general anesthesia, initially with the usual outward gaze deviation, but then a few minutes later one eye went into a downward disconjugate gaze.
Emerged uneventfully with return of normal conjugate gaze
thoughts? normal? never appreciated this sort of gaze deviation before,

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[anaesthetic]

“Stage 2” emergence? Happens in kids.

 

[Iso4ane]

Its bound to happen. I wonder had any other gaze deficits (or ocular muscle deficits) at baseline. CN VI and the abducens muscles is the only unpaired of the occular muscles. Makes sense that lateral gaze deviation is the most noticeable as the CN VI center is waking up.

 

[Ashers]

“Stage 2” emergence? Happens in kids.

I see it in adults too. I check eyes before extubation.

 

[GassYous]

I see it in adults too. I check eyes before extubation.

Why?

 

[coffeebythelake]

I'm specifically referring to the downward gaze deviation on one eye. N

 

[Ashers]

Why?

Glean info. Look at pupil size. I don't give a lot of narcs, but sometimes people are more affected than what I'd assume based on size/dose. I don't check everyone.

There are sometimes shadowing students (college, high school), med students in the OR, so I can teach about stage 2 when I see it.

Edit: I see what I said. Sorry, I don't check everyone. My cat died last night, so little distracted when posting.