Editorial Type:
Article Category: Case Report
 | 
Online Publication Date: Jun 29, 2021

Ambulatory Anesthesia for a Case of Idiopathic Bronchiolitis Obliterans

DDS, MSc, EdD
Page Range: 98 – 106
DOI: 10.2344/anpr-68-01-05
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Bronchiolitis obliterans is rarely described in the nonlung transplant anesthesia literature. This case report describes a 27-year-old female patient with idiopathic bronchiolitis obliterans and dental anxiety who safely received intravenous deep sedation using diphenhydramine, dexmedetomidine, and ketamine in an ambulatory community dental clinic. This report outlines the anesthetic plan developed following a thorough preoperative assessment and review of the key anesthetic considerations of idiopathic bronchiolitis obliterans (eg, potential respiratory complications and appropriateness for the ambulatory dental environment) and discusses the careful anesthetic management of this patient using deep sedation to facilitate comprehensive restorative dentistry.

Keywords: Anesthetic management; Bronchiolitis obliterans; Dexmedetomidine; Dentistry; Deep sedation
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Copyright: © 2021 by the American Dental Society of Anesthesiology
Figure 1.
Figure 1.

Pulmonary function tests from 2019: Flow-volume loop demonstrating an obstructive pattern, severe airflow reduction with reduced forced vital capacity suggestive of gas trapping; and estimated healthy reference for comparison.

Figure 2.
Figure 2.

Axial CT scan from 2019 revealing extensive mosaic attenuation, airway thickening, and bronchiectasis. CT indicates computed tomography.

Figure 3.
Figure 3.

Unremarkable anteroposterior chest radiograph from 2015, which is typical of the disease.