Is asthma still a risk factor for general anesthesia

Objective: To assess the incidence of anaesthetic complications in a cohort of patients with asthma undergoing anaesthesia and surgery. Design, Setting and Patients: 79 patients (who underwent a total of 80 anaesthetics) who were admitted for elective surgery at a major tertiary referral hospital, during a seven month period were enrolled. Data on asthma control and severity were collected prior to surgery, and information on the incidence of intra and post-operative complications were recorded, as well as any alterations to their asthma control following discharge. Results: Perioperative complications occurred in 5 patients (6%), 4 of which developed post-induction bronchospasm, successfully treated in 3 with the fourth having the surgery abandoned. The fifth patient had post-extubation coughing, also successfully managed. The patient who developed severe bronchospasm had poorly controlled asthma. Following discharge 18 patients (24%), reported an increase in severity of their asthma symptoms. This was seen more commonly in patients with poor preoperative asthma control and a higher asthma severity. Conclusions: The incidence of intraoperative complications attributable to asthma was low and generally easily managed. Most asthmatic patients undergo anesthesia without respiratory incident. The low rate of intraoperative respiratory complications does not lead to significant morbidity. However, anaesthetists should focus on optimising their patient’s asthma control as poorly controlled asthma can lead to both intraoperative and postoperative respiratory complications.