Anesthesia for Patients with Asthma

  • Matthew Sisitki
  • Christian H. Bohringer
  • Neal Fleming


Patients with asthma who are scheduled for elective or emergent surgery have unique issues related to airway hyper-reactivity, airflow resistance, and mucus hypersecretion. Anesthesia in these patients is associated with specific risks that are higher than in patients without asthma. Preoperative assessment should focus on characterization of the severity of the patient’s disease, assuring that medical management is optimal and the disease symptoms are stable. The immediate preoperative assessment should confirm the stability of the medical management or work quickly to stabilize acute exacerbations in patients requiring emergency surgery. Because the main intraoperative risk in these patients is bronchospasm, the choice of anesthesia and the anesthetic adjuncts should be selected to minimize this risk. In the event of a severe intraoperative bronchospasm, the differential diagnosis of intraoperative wheezing should be reviewed to eliminate other possible causes and when the diagnosis is confirmed, the bronchospasm should be treated aggressively to avoid progression to more severe complications. Emergence from anesthesia presents a second period of increased risk. Patient management options should be appropriately planned and selected to minimize the risk of recurrent bronchospasm and facilitate the rapid recovery and early mobilization of the patient to minimize postoperative respiratory complications.


Laryngeal Mask Airway Peak Expiratory Flow Volatile Anesthetic Noninvasive Positive Pressure Ventilation Status Asthmaticus 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Matthew Sisitki
    • 1
    • 2
  • Christian H. Bohringer
    • 3
  • Neal Fleming
    • 3
  1. 1.Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal MedicineUniversity of California at Davis, Sacramento Medical CenterSacramentoUSA
  2. 2.VA Northern California Health Care SystemMatherUSA
  3. 3.Department of Anesthesiology and Pain MedicineUniversity of California at DavisSacramentoUSA

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