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Unilateral mydriasis during general anesthesia.

W C Holmgreen, H M Baddour, H B Tilson

    Journal of Oral Surgery (American Dental Association : 1965)
    |October 1, 1979
    PubMed
    Summary
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    Local anesthetic during dental surgery caused pupil dilation (mydriasis), initially mistaken for a serious neurological issue. This highlights a common, benign side effect of local anesthetics in oral surgery.

    Area of Science:

    • Dentistry
    • Anesthesiology
    • Ophthalmology

    Background:

    • Impacted third molar extraction is a common dental surgical procedure.
    • General anesthesia is frequently used for extensive dental surgeries like third molar extraction.
    • Local anesthetics are routinely administered during oral surgery to manage pain.

    Observation:

    • A 24-year-old woman undergoing third molar extraction under general anesthesia received a local anesthetic.
    • The local anesthetic administration resulted in mydriasis (pupil dilation).
    • This mydriasis was initially misidentified as a potential central nervous system deficit.

    Findings:

    • Mydriasis occurred as a direct physiological response to the local anesthetic agent.
    • The observed mydriasis was not indicative of a complication from the general anesthetic.

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  • The event underscores the importance of recognizing localized drug effects.

    • Implications:

    • Clinicians should be aware of potential localized autonomic effects of local anesthetics, such as mydriasis.
    • Differential diagnosis in the operating room should consider common drug side effects.
    • This case emphasizes the need for accurate interpretation of pupillary changes during anesthesia.