Ryan Jannoud (Medicine) tied for first place for Best Case Presentation Poster at the Clark County Medical Society Symposium on February 1 for his research on delayed emergence after general anesthesia, a critical issue in perioperative care. Alongside Dr. Vladislav Zhitny (alumnus of the Kirk Kerkorian School of Medicine at UNLV, Class of 2022) from NYU’s Department of Anesthesiology, Perioperative Care, and Pain Medicine, and co-author Brett Dixon (Class of 2027), Jannoud presented a case of a 67-year-old female who experienced prolonged unresponsiveness after surgery despite stable intraoperative conditions. The case emphasized the complexity of diagnosing delayed emergence, highlighting possible causes such as pharmacokinetic effects, metabolic imbalances, neurovascular complications, and anesthesia-related factors. The patient’s condition deteriorated after an initial extubation attempt, prompting a stroke code, but a CT scan ruled out a neurological event. Further investigation revealed severe hypercapnic respiratory acidosis, which was successfully managed with ventilatory support, leading to the patient's recovery. This case underscores the importance of a systematic, evidence-based approach in diagnosing and managing delayed emergence, ensuring timely intervention and improved patient outcomes. Jannoud’s work highlights a critical perioperative challenge, reinforcing the need for enhanced diagnostic workflows in anesthesiology to reduce postoperative complications and improve patient safety.