Is Asthma still a Risk Factor for General Anesthesia
International Journal of Anesthesia and Clinical Medicine
Volume 2, Issue 1, January 2014, Pages: 8-12
Received: Jan. 6, 2014;
Published: Mar. 30, 2014
Views 2621 Downloads 531
Ji Li, Resident Medical Officer, Royal North Shore Hospital, Sydney, Australia
Ross Mac Pherson, Clinical Associate Professor, Department of Anesthesia and Pain Management, Royal North Shore Hospital, Sydney, Australia
Follow on us
Objective: To assess the incidence of anaesthetic complications in a cohort of patients with asthma undergoing anaesthesia and surgery. Design, Setting and Patients: 79 patients (who underwent a total of 80 anaesthetics) who were admitted for elective surgery at a major tertiary referral hospital, during a seven month period were enrolled. Data on asthma control and severity were collected prior to surgery, and information on the incidence of intra and post-operative complications were recorded, as well as any alterations to their asthma control following discharge. Results: Perioperative complications occurred in 5 patients (6%), 4 of which developed post-induction bronchospasm, successfully treated in 3 with the fourth having the surgery abandoned. The fifth patient had post-extubation coughing, also successfully managed. The patient who developed severe bronchospasm had poorly controlled asthma. Following discharge 18 patients (24%), reported an increase in severity of their asthma symptoms. This was seen more commonly in patients with poor preoperative asthma control and a higher asthma severity. Conclusions: The incidence of intraoperative complications attributable to asthma was low and generally easily managed. Most asthmatic patients undergo anesthesia without respiratory incident. The low rate of intraoperative respiratory complications does not lead to significant morbidity. However, anaesthetists should focus on optimising their patient’s asthma control as poorly controlled asthma can lead to both intraoperative and postoperative respiratory complications.
General Anesthesia, Asthma, Bronchospasm, Complications
To cite this article
Ross Mac Pherson,
Is Asthma still a Risk Factor for General Anesthesia, International Journal of Anesthesia and Clinical Medicine.
Vol. 2, No. 1,
2014, pp. 8-12.
Asthma Management Handbook 2006. National Asthma Council Australia. http://www.nationalasthma.org.au/handbook
Burburan SM, Xisto DG, Rocco PR. Anaesthetic management in asthma. Minerva Anestesiol 2007; 73: 357-365.
Woods BD, Sladen RN. Perioperative considerations for the patient with asthma and bronchospasm. Br J Anaesth 2009; 103: 57-65.
Tirumalasetty J, Grammer LC. Asthma, surgery, and general anesthesia: A review. J Asthma 2006; 43: 251-254.
Converse JG and Smotilla MM. Anesthesia and the asthmatic. Anesthes Analg 1965;40:336-342.
Olsson GL. Bronchospasm during anesthesia. A computer-aided incidence study of 136,929 patients. Acta Anaesthesiol Scand 1987; 31: 244-252.
Warner DO, Warner MA, Barnes RD et al. Perioperative respiratory complications in patients with asthma. Anesthesiology 1996; 85: 460-467.
Gold MI, Helrich M. A study of complications related to anesthesia in asthmatic patients. Anesth Analg 1963; 42: 238-293.
Pizov R, Brown RH, Weiss YS et al. Wheezing during induction of general anesthesia in patients with and without asthma. A randomized, blind trial. Anesthesiology 1995; 82: 1111-1116.
Kasaba T, Suga R, Matsuoka H, Iwasaki T, Hidaka N, Takasaki M. Comparison of epidural anesthesia and general anesthesia for patients with bronchial asthma. Masui 2000; 49: 1115-1120.
Kumeta Y, Hattori A, Mimura M, Kishikawa K, Namiki A. A survey of perioperative bronchospasm in 105 patients with reactive airway disease. Masui 1995; 44: 396-401.