Anesthetic Management for an Elderly Patient With Severe Bronchiectasis

Bronchiectasis is a clinical syndrome characterized by coughing and sputum production in the presence of abnormal thickening and dilatation of the bronchial walls. We report the successful anesthetic management of a 91-year-old patient with severe bronchiectasis undergoing left marginal mandibulectomy for squamous cell carcinoma of the mandibular gingiva. In this case, we utilized respiratory prehabilitation for preoperative optimization of the patient's respiratory function and intravenous moderate sedation with dexmedetomidine and pentazocine plus excellent local anesthesia intraoperatively rather than an intubated general anesthetic. During the procedure, the patient's vital signs were stable, and she did not have any psychological or physical complaints like anxiety or pain and was discharged from the hospital without any complications. Considering the high risk of respiratory complications, intravenous moderate sedation may be a better option than general anesthesia for some surgeries in patients with severe bronchiectasis. These strategies may be useful options for older patients with impaired respiratory function undergoing oral surgery procedures.