Anesthesia management in double balloon enteroscopy for a patient with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu)

This case report discusses the anesthesia management of a 70-year-old male with Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu disease, who underwent double balloon enteroscopy (DBE) for the treatment of gastrointestinal angiodysplasia. The patient, with a history of anemia requiring frequent blood transfusions, was managed with deep sedation using a combination of midazolam, dexmedetomidine, and propofol during the procedure. The sedation approach was tailored to the patient's comorbidities and preference against general anesthesia. The procedure was completed successfully without complications, and the patient was discharged the following day. The use of dexmedetomidine and propofol ensured stable hemodynamy and airway security, making it an effective sedation strategy for complex gastrointestinal procedures in elderly patients. The report highlights the importance of appropriate sedation protocols, particularly for patients with multiple comorbidities, and emphasizes the need for further research on sedation depth monitoring to optimize anesthetic care.