Bronchial hyperreactivity inherent asthma, creates a high risk of spasms during surgery, which is a dangerous situation.
Immersing the patient in general anesthesia leads to a decrease in the tone of the pharynx and palate, an increase in mucus, a decrease in lung volume. These factors contribute to obstruction and make breath even more difficult. All this in combination makes surgery very difficult. sick with bronchial asthma and requires the adoption of certain measures and the appointment of special procedures and drugs.
Preparing the patient before surgery
Preoperative preparation of sufferers bronchial asthma Patients are administered individually and, depending on their overall health and other factors, may include the following procedures or recommendations:
- Inhaling β 2 -adrenoreceptor agonists are prescribed to relieve bronchospasm ;
- In case of possible occurrence of postoperative complications, hydrocortisone or prednisone If the expiratory volume is less than 80%, steroids are prescribed;
- In the case of an infectious process, the use of antibiotics is necessary;
- Correction of electrolyte and water balance is required to avoid the development of cardiac arrhythmias, hypomagnemia, hypokalemia or hyperglycemia;
- Assigned to prophylactic use of cromolyn to prevent the release of mediators and mast cell degranulation;
- Physiotherapy is carried out to improve the drainage process in the bronchi and the sputum clearance;
- It is also highly desirable for the patient to quit smoking (if there is an addiction).
What type of anesthesia is suitable for asthma?
Patients with the symptoms bronchial asthma, endotracheal intubation is contraindicated. This means that for the implementation of surgical procedures applied local anesthesia in order to avoid complications that may occur after surgery. This applies to women in the state pregnancy, as well as women in labor. However, in situations where local anesthesia is not possible, a preventive treatment of an anti-obstructive nature is prescribed by a doctor. Also for patients with asthma, a combination of local and general anesthesia is indicated.
In operating practice, such anesthetics as halothane, isofluten, sevoflurane, belonging to the inhalation group are used. Ketamine, propofol can be used intravenously; as opioids used fentanyl. Among muscle relaxants, the use of rocuronium, vecuronium, pancuronium, cisatracuria is actual.In the role of local anesthetic is used lidocaine.