«Anesteziologiya i Reanimatologiya
Abstracts of the articles
ANAESTHESIA FOR PATIENTS WITH OBSTRUCTIVE AIRWAY DISEASES
, Keller V.
, Silvanus M.T.
1Essen-Mitte Clinics, Germany; 2Duisburg-Essen University, Germany
correspondence to: H. Groeben
Obstructive lung diseases like asthma or chronic obstructive lung diseases have a high prevalence
and are one of the four most frequent causes of death. Obstructive lung diseases can be significantly
influenced by the choice of anesthetic techniques and anesthetic agents. Basically, the severity of the COPD
and the degree of bronchial hyperreactivity will determine the perioperative anesthetic risk. This risk has to be
assessed by a thorough preoperative evaluation and will give the rationale on which to decide for the
adequate anaesthetic technique. In particular, airway instrumentation can cause severe reflex
bronchoconstriction. The use of regional anaesthesia alone or in combination with general anaesthesia can
help to avoid airway irritation and leads to reduced postoperative complications. Prophylactic antiobstructive
treatment, volatile anesthetics, propofol, opioids, and an adequate choice of muscle relaxants minimize the
anesthetic risk, when general anesthesia is required. In case, despite all precautions intra-operative
bronchospasm occurs, deepening of anaesthesia, repeated administration of ß2-adrenergic agents and
parasympatholytics, and a single systemic dose of corticosteroids represent the main treatment options.
obstructive lung disease, anaesthetic techniques, anaesthetic risk, regional anaesthesia