Guideline-oriented perioperative management of patients with bronchial asthma and chronic obstructive pulmonary disease.
Increased airway hyperresponsiveness is a major concern in the perioperative management of patients with bronchial asthma and chronic obstructive pulmonary disease. Guidelines using evidence-based medicine are continually being updated and published regarding the diagnosis, treatment, and prevention of these respiratory disorders. Perioperative management in these patients involves: (1) adequate control of airway hyperresponsiveness, including detection of purulent sputum and infection before surgery; (2) evidence-based control of anesthesia; and (3) the aggressive use of beta-2 adrenergic stimulants and the systemic administration of steroids for the treatment of acute attacks. Good preoperative control, including the use of leukotriene antagonists, can reduce the incidence of life-threatening perioperative complications. Awareness of recent guidelines is thus important in the management of patients with airway hyperresponsiveness. This review covers the most recent guidelines for the perioperative management of patients with bronchial asthma and chronic obstructive pulmonary disease.
Yamakage
Michiaki
M
Department of Anesthesiology, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
Iwasaki
Sohshi
S
Namiki
Akiyoshi
A
D000758:Anesthesia / Q000592:standards*; D000777:Anesthetics; D001249:Asthma / Q000150:complications* / Q000628:therapy; D017408:Guidelines as Topic; D006801:Humans; D019990:Perioperative Care / Q000592:standards*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000628:therapy; D009626:Terminology as Topic
D000777:Anesthetics