{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T01:10:08Z","timestamp":1742865008781,"version":"3.40.2"},"reference-count":23,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>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\u2019s 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\u2019s 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.<\/jats:p>","DOI":"10.2344\/23-0036","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:02:28Z","timestamp":1742860948000},"page":"33-36","source":"Crossref","is-referenced-by-count":0,"title":["Anesthetic Management for an Elderly Patient With Severe Bronchiectasis"],"prefix":"10.2344","volume":"72","author":[{"given":"Tamayo","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Dental Anesthesiology, Division of Oral and Maxillofacial Surgery and Oral Medicine, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuhiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Division of Oral and Maxillofacial Surgery and Oral Medicine, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanako","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Koizumi","sequence":"additional","affiliation":[{"name":"Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisanobu","family":"Kamio","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Division of Oral and Maxillofacial Surgery and Oral Medicine, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aya","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Division of Oral and Maxillofacial Surgery and Oral Medicine, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kana","family":"Oue","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Division of Oral and Maxillofacial Surgery and Oral Medicine, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuru","family":"Doi","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshitaka","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1191","reference":[{"key":"i1878-7177-72-1-33-b01","series-title":"Eur Respir J","first-page":"1","article-title":"European Respiratory Society guidelines for the management of adult bronchiectasis","volume":"50","author":"Polverino","year":"2017","unstructured":"Polverino E,\nGoeminne PC,\nMcDonnell MJ, et al. European Respiratory Society guidelines for the management of adult bronchiectasis. Eur Respir J. 2017;50:1\u201323."},{"key":"i1878-7177-72-1-33-b02","series-title":"Thorax","first-page":"179","article-title":"Atopy, immunological changes, and respiratory function in bronchiectasis","volume":"39","author":"Murphy","year":"1984","unstructured":"Murphy MB,\nReen DJ,\nFitzgerald MX. Atopy, immunological changes, and respiratory function in bronchiectasis. Thorax. 1984;39:179\u2013184."},{"key":"i1878-7177-72-1-33-b03","series-title":"Chest","first-page":"815","article-title":"Bronchiectasis","volume":"134","author":"O\u2019Donnell","year":"2008","unstructured":"O\u2019Donnell AE. Bronchiectasis. Chest. 2008;134:815\u2013823."},{"key":"i1878-7177-72-1-33-b04","series-title":"Nat Rev Dis Primers","first-page":"45","article-title":"Bronchiectasis","volume":"4","author":"Chalmers","year":"2018","unstructured":"Chalmers JD,\nChang AB,\nChotirmall SH,\nDhar R,\nMcShane PJ. Bronchiectasis. Nat Rev Dis Primers. 2018;4:45."},{"key":"i1878-7177-72-1-33-b05","series-title":"Acta Anaesthesiol Scand","first-page":"518","article-title":"Anaesthetic considerations in Kartagener\u2019s syndrome \u2013 a case report","volume":"48","author":"Mathew","year":"2004","unstructured":"Mathew PJ,\nSadera GS,\nSharafuddin S,\nPandit B. Anaesthetic considerations in Kartagener\u2019s syndrome \u2013 a case report. Acta Anaesthesiol Scand. 2004;48:518\u2013520."},{"key":"i1878-7177-72-1-33-b06","series-title":"Lancet","first-page":"1377","article-title":"Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial","volume":"388","author":"Schaller","year":"2016","unstructured":"Schaller SJ,\nAnstey M,\nBlobner M, et al. Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial. Lancet. 2016;388:1377\u20131388."},{"key":"i1878-7177-72-1-33-b07","series-title":"Intensive Care Med","first-page":"171","article-title":"The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review","volume":"43","author":"Tipping","year":"2017","unstructured":"Tipping CJ,\nHarrold M,\nHolland A,\nRomero L,\nNisbet T,\nHodgson CL. The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review. Intensive Care Med. 2017;43:171\u2013183."},{"key":"i1878-7177-72-1-33-b08","series-title":"Arch Phys Med Rehabil","first-page":"774","article-title":"Pulmonary rehabilitation in individuals with non-cystic fibrosis bronchiectasis: a systematic review","volume":"98","author":"Lee","year":"2017","unstructured":"Lee AL,\nHill CJ,\nMcDonald CF,\nHolland AE. Pulmonary rehabilitation in individuals with non-cystic fibrosis bronchiectasis: a systematic review. Arch Phys Med Rehabil. 2017;98:774\u2013782.e1."},{"key":"i1878-7177-72-1-33-b09","series-title":"Br J Anaesth","first-page":"919","article-title":"Anaesthesia for Kartagener\u2019s syndrome","volume":"85","author":"Reidy","year":"2000","unstructured":"Reidy J,\nSischy S,\nBarrow V. Anaesthesia for Kartagener\u2019s syndrome. Br J Anaesth. 2000;85:919\u2013921. 11732534"},{"key":"i1878-7177-72-1-33-b10","series-title":"Masui","first-page":"610","article-title":"Difficult airway management for general anesthesia in two patients with Kartagener syndrome","volume":"59","author":"Andoh","year":"2010","unstructured":"Andoh T,\nMomota Y,\nMurata K,\nKotani J. Difficult airway management for general anesthesia in two patients with Kartagener syndrome. Masui. 2010;59:610\u2013613."},{"key":"i1878-7177-72-1-33-b11","series-title":"Masui","first-page":"866","article-title":"Anesthesia for a patient with Kartagener\u2019s syndrome undergoing ambulatory bilateral breast cancer surgery","volume":"52","author":"Shirakami","year":"2003","unstructured":"Shirakami G,\nNamba T,\nMatsuura S,\nFukuda K. Anesthesia for a patient with Kartagener\u2019s syndrome undergoing ambulatory bilateral breast cancer surgery. Masui. 2003;52:866\u2013869."},{"key":"i1878-7177-72-1-33-b12","series-title":"Int J Surg","first-page":"1050","article-title":"Surgical treatment of bronchiectasis: a retrospective observational study of 260 patients","volume":"12","author":"Jin","year":"2014","unstructured":"Jin YX,\nZhang Y,\nDuan L,\nYang Y,\nJiang GN,\nDing JA. Surgical treatment of bronchiectasis: a retrospective observational study of 260 patients. Int J Surg. 2014;12:1050\u20131054."},{"key":"i1878-7177-72-1-33-b13","series-title":"Medicina (Kaunas)","first-page":"12","article-title":"Conscious sedation in dentistry","volume":"55","author":"Fiorillo","year":"2019","unstructured":"Fiorillo L. Conscious sedation in dentistry. Medicina (Kaunas). 2019;55:12."},{"key":"i1878-7177-72-1-33-b14","series-title":"Ann Maxillofac Surg","first-page":"283","article-title":"Comparison of vital surgical parameters, after administration of midazolam and dexmedetomidine for conscious sedation in minor oral surgery","volume":"9","author":"Sivasubramani","year":"2019","unstructured":"Sivasubramani S,\nPandyan DA,\nRavindran C. Comparison of vital surgical parameters, after administration of midazolam and dexmedetomidine for conscious sedation in minor oral surgery. Ann Maxillofac Surg. 2019;9:283\u2013288."},{"key":"i1878-7177-72-1-33-b15","series-title":"Drugs","first-page":"1119","article-title":"Dexmedetomidine: a review of its use for sedation in the intensive care setting","volume":"75","author":"Keating","year":"2015","unstructured":"Keating GM. Dexmedetomidine: a review of its use for sedation in the intensive care setting. Drugs. 2015;75:1119\u20131130."},{"key":"i1878-7177-72-1-33-b16","series-title":"BMC Anesthesiol","first-page":"127","article-title":"Dexmedetomidine for prevention of postoperative pulmonary complications in patients after oral and maxillofacial surgery with fibular free flap reconstruction: a prospective, double-blind, randomized, placebo-controlled trial","volume":"20","author":"Liu","year":"2020","unstructured":"Liu Y,\nZhu X,\nZhou D,\nHan F,\nYang X. Dexmedetomidine for prevention of postoperative pulmonary complications in patients after oral and maxillofacial surgery with fibular free flap reconstruction: a prospective, double-blind, randomized, placebo-controlled trial. BMC Anesthesiol. 2020;20:127."},{"key":"i1878-7177-72-1-33-b17","article-title":"Dexdor (dexmedetomidine): EU Summary of Product Characteristics","author":"European Medicines Agency","year":"2015","unstructured":"European Medicines Agency. Dexdor (dexmedetomidine): EU Summary of Product Characteristics, 2015. Accessed May 4, 2015. http:\/\/www.ema.europa.eu\/"},{"key":"i1878-7177-72-1-33-b18","series-title":"J Craniofac Surg","first-page":"e70","article-title":"Analgesia-based sedation for oral surgery in patients with chronic respiratory obstructive disease","volume":"34","author":"Takahashi","year":"2023","unstructured":"Takahashi T,\nYoshida M,\nOno S, et al. Analgesia-based sedation for oral surgery in patients with chronic respiratory obstructive disease. J Craniofac Surg. 2023;34:e70\u2013e74."},{"key":"i1878-7177-72-1-33-b19","series-title":"Drug Saf","first-page":"173","article-title":"Adverse effects of opioid agonists and agonist-antagonists in anaesthesia","volume":"19","author":"Bowdle","year":"1998","unstructured":"Bowdle TA. Adverse effects of opioid agonists and agonist-antagonists in anaesthesia. Drug Saf. 1998;19:173\u2013189."},{"key":"i1878-7177-72-1-33-b20","series-title":"Anesth Prog","first-page":"36","article-title":"Effect of time on clinical efficacy of topical anesthesia","volume":"56","author":"Bhalla","year":"2009","unstructured":"Bhalla J,\nMeechan JG,\nLawrence HP,\nGrad HA,\nHaas DA. Effect of time on clinical efficacy of topical anesthesia. 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J Endod. 1986;12:486\u2013491."},{"key":"i1878-7177-72-1-33-b23","series-title":"J Endod","first-page":"1370","article-title":"Effects of epinephrine on lidocaine pharmacokinetics and blood volume in the dental pulp","volume":"40","author":"Hashimoto","year":"2014","unstructured":"Hashimoto S,\nYamashiro M,\nFujita K,\nYasuda A,\nSunada K. Effects of epinephrine on lidocaine pharmacokinetics and blood volume in the dental pulp. J Endod. 2014;40:1370\u20131374."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/72\/1\/article-p33.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/72\/1\/article-p33.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/72\/1\/article-p33.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:04:14Z","timestamp":1742861054000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/72\/1\/article-p33.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":23,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.2344\/23-0036","relation":{},"ISSN":["1878-7177","0003-3006"],"issn-type":[{"value":"1878-7177","type":"electronic"},{"value":"0003-3006","type":"print"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}