Anaesthesia for the asthmatic

Acute attacks of asthma developing during induction of anaesthesia or intra-operatively are greatly feared by anaesthetists, because of the severity of these attacks when they do occur. All patients with asthma should receive optimal therapy aimed at producing maximal reversal of airways obstruction before being submitted to anaesthesia and surgery. Intubation under light anaesthesia without prior local analgesia of the upper airways is undoubtedly the greatest danger for the asthmatic patient and should be avoided at all costs. An understanding of the principles underlying the assessment and management of asthma is important for the anaesthetist, not only for the safe conduct of anaesthesia but also because he will frequently need to give advice on such aspects in the pre- and postoperative periods.