Endoscopic Dacryocystorhinostomy in an Elderly Patient With Severe Left Ventricular Dysfunction Under Individualized Monitored Anesthesia Care

Endoscopic dacryocystorhinostomy is generally performed under general anaesthesia. However, elderly patients with multiple comorbidities can impose significant risk during conduction of general anesthesia. We report safe management of an elderly patient with hypothyroidism and severe left ventricular systolic dysfunction having implantable cardioverter defibrillator planned for endoscopic dacryocystorhinostomy using monitored anesthesia care. Emphasis is given to the specific drug choices and technique of oxygen supplementation along with assisted local anesthesia in this scenario.