If the patient had a severe asthmatic attack in the operating room before the induction of anesthesia, would you proceed with the anesthetic or postpone the surgery?
Answer:
First, medical treatment should be given to relieve the asthmatic attack. Elective surgery should be postponed, the patient reevaluated carefully, and his asthma better optimized. In the case of emergency surgery, such as acute appendicitis, the surgery can be performed after the asthmatic attack is successfully treated. Regional anesthesia, if feasible, should be considered. During surgery, the medical treatment should be continued.
Reference(s):
- Dewachter P, Mouton-Faivre C, Emala CW, et al. Case scenario: bronchospasm during anesthetic induction. Anesthesiology. 2011;114:1200-1210.
- Woods BD, Sladen RN. Perioperative considerations for the patient with asthma and bronchospasm. Br J Anaesth. 2009;103(suppl 1):i57-i65.