Asthma and anesthesia: what are the risks?

When people think of anesthesia, they often think of general anesthesia. General anesthesia involves falling asleep to avoid feeling pain during surgery.

People with asthma are more likely to develop complications from general anesthesia than people without asthma. The risk is greatest in people with uncontrolled or severe asthma.

People with mild, well-controlled asthma are generally safe to undergo general anesthesia, but it’s always a good idea to discuss the risks with your doctor ahead of time.

It is important to inform the medical team before your surgery if you have asthma. For people with controlled and mild asthma, anesthesia can generally be administered safely.

For people with unmanaged asthma, healthcare professionals may recommend postpone elective surgery until your asthma is well managed, especially if you have other risk factors this could increase your chances of complications.

Some potential complications include:

Anesthesia and bronchospasm

Asthma is characterized by inflammation of the airways which can trigger bronchospasm.

Bronchospasm occurs when the small muscles in your lungs contract. They cause the airways to narrow and make it harder to breathe.

People with asthma have a higher risk of complications when they receive anesthesia because there is a increased chances to develop a low level of oxygen in the blood due to these muscle spasms.

Bronchospasm can be triggered by intubation during surgery, allergies to latex-based medical devices, and hypersensitivity to anesthetics. Low blood oxygen levels can be life threatening in severe cases.

In a older study from 2005, the researchers found that among 103 cases of bronchospasm during surgery, 22% were caused by an allergic reaction.

Of the non-allergic cases that occurred at the start of or during anesthesia, 35% of cases were triggered by respiratory tract irritation, 23% by problems with an endotracheal tube, and 14% by aspiration of stomach contents .

More current (and broader) research is needed.

Children are particularly susceptible to developing adverse respiratory events during anesthesia.

People with asthma are at an increased risk of developing bronchospasm when they are given general anesthesia.

Bronchospasm decreases the amount of air that can enter and leave your lungs, causing hypoxemia. The medical term hypoxemia is used to describe a low level of oxygen in the blood.

Hypoxemia can sometimes lead to another condition, hypoxia, where the tissues in your body are not getting enough oxygen.

A lack of oxygen in your brain, heart, or other major organs can lead to organ damage within minutes. In severe cases, hypoxia can lead to death.

Most complications from low oxygen in the blood occur shortly after surgery in the recovery room.

Postoperative respiratory complications are reported between 2 and 19 percent of surgeries. Having a history of smoking or severe asthma are risk factors for developing respiratory complications after surgery.

Postoperative respiratory complications include:

In a 2016 study, researchers suggest that people with asthma have a higher risk of developing the following complications after surgery:

You can minimize your risk of developing postoperative complications by making sure your asthma is well controlled before elective surgery. You can also keep track of any deep breathing exercises your treatment team gives you after surgery and openly communicate with your healthcare team how you are feeling.

You will also likely be encouraged to participate in regular physical activity to reduce your risk of getting an infection.

In the weeks leading up to your surgery, you can prepare and minimize your risk of complications by:

  • avoid any known asthma triggers
  • reduce physical and mental stress
  • continue to take your prescribed medications regularly
  • reduce or avoid smoking if you are a current smoker

Your anesthetist or doctor may recommend that you take corticosteroids in the days before your surgery to reduce inflammation in the lungs and lower your risk of complications.

Research has shown that they are most beneficial when given at least 2-3 days before surgery.

The chances of developing complications from the anesthesia are usually low if your asthma is well controlled. In most cases, the complications are manageable and have no long-term health effects.

The risk of surgical complications varies depending on factors such as:

  • the type of surgery
  • the scope of your operation
  • the severity of your asthma
  • your overall health

Your healthcare team can help you determine if you have a higher risk of developing a particular complication.

People with well-managed asthma can usually be given anesthesia without developing complications.

However, even if your asthma is being managed well, it’s a good idea to speak with your healthcare team before your surgery to make sure you’re a good candidate for anesthesia.

You should also tell the doctor and surgeon if you have a flare-up of your asthma symptoms in the weeks before your surgery.

If your asthma is currently severe or not well controlled, it is generally recommended that you postpone elective surgeries until you have managed it better to avoid complications.

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About Catherine Sherrill

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