A High Index of Awareness About the Inherent Complications of Thoracic Segmental Spinal Anesthesia: A Case of Mastectomy With Bronchiectasis Under Thoracic Segmental Spinal Anesthesia

General anesthesia is the gold standard for breast cancer surgeries. Considering the nature of the surgery and its associated pain, various regional techniques are used as an adjunct to general anesthesia. Regional anesthesia as a sole anesthetic technique for breast cancer surgery is an upcoming technique - especially in high-risk patients considering the risk-benefit ratio, various regional blocks like pectoralis major block, pectoralis minor block, and erector spinae block - in which thoracic segmental spinal anesthesia is the recent one. Here we present a 68-year-old patient with bronchiectasis for radical mastectomy under thoracic segmental spinal anesthesia with isobaric bupivacaine at T4-5 intervertebral space, achieving blockade at T1 to T8 level. The patient complained of respiratory distress and hoarseness of voice after 40 minutes of surgery, which was successfully managed. Early recognition and timely management of the untoward effect helped us to complete the case uneventfully. In this article, we emphasize that patient safety and selection of the type of anesthesia are of utmost importance, and hoarseness of voice and sedation caused due to the adjuvant added intrathecally should always be considered alarming sign during a thoracic segmental spinal anesthesia as well as conventional lumbar spinal anesthesia.