Preparing Your Patients with Asthma for Surgery
Patients who have asthma are at risk for complications during and after surgery
These complications include acute bronchoconstriction triggered by intubation, hypoxemia and possible hypercapnia, impaired effectiveness of cough, atelectasis, and respiratory infection, and, if a history of sensitivity is present, reactions to latex exposure or some anesthetic agents.
The following actions are recommended to reduce the risk of complications during surgery:
- Before surgery, review the level of asthma control, medication use (especially oral systemic corticosteroids within the past 6 months), and pulmonary function.
- Provide medications before surgery to improve lung function if lung function is not well controlled. A short course of oral systemic corti costeroids may be necessary.
- For patients receiving oral systemic corticosteroids during the 6 months prior to surgery and for selected patients on long-term high-dose ICS, give 100 mg hydrocortisone every 8 hours intravenously during the surgical period, and reduce the dose rapidly within 24 hours after surgery.
Reference: Guidelines for the Diagnosis and Management of Asthma, National Asthma Education and Prevention Program of the National Heart, Lung and Blood Institute, Expert Panel Report 3, 2007.