Perioperative management for patients with bronchial asthma

To minimize the risks of perioperative respiratory complications in patients with asthma undergoing general anesthesia, the key is detailed preoperative assessment of asthmatic patients. A patient with a history of frequent exacerbations, aspirin-exacerbated respiratory disease, or recent airway infection has a severe risk of perioperative exacerbation. Pre- operative intervention with anti-inflammatory and bronchodilatory medication should be considered if asthma is poorly controlled before surgery. Another key is adequate anesthetic plan suppressing or avoiding bronchial constriction, including proper selection of anesthetic and appropriate depth of anesthesia at any time point during surgery. Intraoperative bron- chospasm must be managed promptly using bronchodilators and/or steroid. Thorough perioperative management can lead to an uneventful course in patients with asthma.