Asthma is a chronic inflammatory disorder of the airways characterized by hyperresponsiveness, variable airflow obstruction, and airway remodeling. In the OR, we’re less concerned about chronic control and more focused on acute airway events…namely, bronchospasm.
Bronchospasm during general anesthesia can be insidious. You may see rising peak airway pressures, decreased tidal volumes, wheezing if you’re lucky…and if you’re unlucky…desaturation and hypotension. Time is tissue. That’s when it’s time to get medications like albuterol and epinephrine out of the anesthesia cart.
In today’s episode, Sass and Jeremy discuss the pharmacology of albuterol and epinephrine as they relate to the management of intraoperative bronchospasm.
References
- Maddah SA, et al. The Effect of Albuterol Spray on Hypoxia and Bronchospasm in Patients with Chronic Obstructive Pulmonary Disease (COPD) under General Anesthesia: A bouble-Blind Randomized Clinical Trial. Ethiop J Health Sci. 2023;33(3):491-498.
- von Ungern-Sternberg BS, et al. Effect of Albuterol Premedication vs Placebo on the Occurrence of Respiratory Adverse Events in Children Undergoing Tonsillectomies: The REACT Randomized Clinical Trial. JAMA Pediatr. 2019;173(6):527-533.
Resources/information discussed in podcast
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