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Bronchospasm associated with enflurane exposure--three case reports

C J Lowry, B P Fielden

    Anaesthesia and Intensive Care
    |August 1, 1976
    PubMed
    Summary
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    Enflurane may trigger severe bronchospasm in asthma patients. Halothane gas protected against this reaction, but high blood levels did not, suggesting caution when using enflurane for anesthesia in asthmatics.

    Area of Science:

    • Anesthesiology
    • Pulmonary Medicine
    • Pharmacology

    Background:

    • Asthma is a chronic respiratory condition characterized by airway inflammation and hyperresponsiveness.
    • Anesthetic agents are frequently used in patients with asthma for surgical procedures.
    • Identifying potential triggers for bronchospasm in asthmatic patients is crucial for safe anesthetic management.

    Observation:

    • Three cases of severe bronchospasm were observed in patients with known asthma after receiving enflurane.
    • Common causes of bronchospasm, such as irritants or allergens, were ruled out in these cases.
    • The administration of enflurane appeared to be the precipitating factor for the bronchospastic events.

    Findings:

    • Bronchospasm occurred despite the absence of other identifiable causes.

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  • Moderately high concentrations of halothane in inhaled gases demonstrated a protective effect against enflurane-induced bronchospasm.
  • Conversely, moderately high blood concentrations of halothane did not prevent the bronchospasm, indicating a potential difference in mechanism or site of action.

    • Implications:

    • Enflurane should be administered with caution to patients with a history of asthma.
    • Further research is warranted to elucidate the mechanism underlying enflurane-induced bronchospasm in asthmatics.
    • The findings suggest that inhaled anesthetics like halothane may play a role in mitigating or preventing bronchospasm during anesthesia in susceptible individuals.