Perioperative considerations for the patient with asthma and bronchospasm

Br J Anaesth. 2009 Dec:103 Suppl 1:i57-65. doi: 10.1093/bja/aep271.


The incidence of asthma is increasing worldwide, but morbidity and mortality are decreasing because of improvements in medical care. Although the incidence of severe perioperative bronchospasm is relatively low in asthmatics undergoing anaesthesia, when it does occur it may be life-threatening. The keys to an uncomplicated perioperative course are assiduous attention to detail in preoperative assessment, and maintenance of the anti-inflammatory and bronchodilatory regimens through the perioperative period. Potential trigger agents should be identified and avoided. Many routinely used anaesthetic agents have an ameliorative effect on airway constriction. Nonetheless, acute bronchospasm can still occur, especially at induction and emergence, and should be promptly and methodically managed.

Publication types

  • Review

MeSH terms

  • Anesthesia / adverse effects
  • Anesthesia / methods
  • Asthma / complications*
  • Asthma / drug therapy
  • Asthma / physiopathology
  • Bronchial Spasm / drug therapy
  • Bronchial Spasm / etiology*
  • Bronchial Spasm / physiopathology
  • Bronchodilator Agents / therapeutic use
  • Humans
  • Intraoperative Complications*
  • Perioperative Care / methods*


  • Bronchodilator Agents