A patient with asthma will have fewer problems during and after surgery if he or she is carefully prepared in advance. Emergency surgery may limit the number of steps that can be taken.
Treatment of the asthma:
(1) Administer inhaled beta-2 agonists for bronchospasm.
(2) Administer corticosteroids if FEV1 is < 80% of predicted OR if postoperative complications expected.
Interventions:
(1) Discontinue smoking several weeks in advance of surgery (which will hopefully continue afterwards).
(2) Eradicate all infections prior to surgery.
(3) Treat cardiopulmonary disease.
(4) Screen the patient for cardiac arrhythmias.
(5) Make sure that the patient is well-hydrated.
(6) Correct any electrolyte disturbances.
(7) Provide cromolyn to prevent mast cell degranulation.
(8) Consider chest physiotherapy to aid bronchial drainage and sputum clearance.
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