Answer:

Propofol may be the induction agent of choice for the hemodynamically stable patient with reactive airways. In comparison to induction with thiopental, thiamylal, or methohexital, 2.5 mg per kg propofol induction resulted in a significantly lower incidence of wheezing after tracheal intubation in asthmatic patients. The incidence of wheezing was 0%, 45%, and 26% in patients who received propofol, a thiobarbiturate, and oxybarbiturate, respectively. Another study in unselected patients found a significantly lower respiratory resistance after tracheal intubation following induction with propofol than with thiopental or etomidate. Nevertheless, propofol-induced bronchospasm has been reported in patients with allergic rhinitis and should be used with caution in patients with a high allergic component.

• Eames WO, Rooke GA, Wu RS, et al. Comparison of the effects of etomidate, propofol, and thiopental on respiratory resistance after tracheal intubation. Anesthesiology. 1996;84:1307-1311.
• Nishiyama T, Hanaoka K. Propofol-induced bronchoconstriction: two case reports. Anesth Analg. 2001;93:645-646.
• Pizov R, Brown RH, Weiss YS, et al. Wheezing during induction of general anesthesia in patients with and without asthma. A randomized, blinded trial. Anesthesiology. 1995;82:1111-1116.