title: The risk of bronchospasm in asthmatics undergoing general anaesthesia and/or intravascular administration of radiographic contrast media. physiopatology and clinical/functional evaluation.
abstract: It is well known that patients suffering from bronchial asthma undergoing to surgical procedures requiring general anaesthesia (GA) or the administration of water soluble radiographic contrast media (RCM) experience a risk of potentially severe bronchospasm. Nevertheless, little attention has been devoted on the possible preventive measures to reduce the occurrence of this potentially life-threatening event. It has been shown that the most important risk factor for bronchospasm during GA induction and/or the use of RCM is represented by a high degree of bronchial hyperreactivity with airway instability not adequately controlled by long-term anti-inflammatory treatment. The aim of this review is to underline the need for an accurate clinical and functional evaluation of asthmatics (especially those with a relevant degree of asthma severity) undergoing GA or administration of RCM. Guidelines shared by pulmonologists, allergologists, anesthesiologists and radiologists should be produced in the future for a better evaluation and management of these patients. General practitioner plays an important role in managing asthmatic patients in "Real Life". It is likely that "Real Life"--optimally controlled asthmatics could undergo GA/RCM with lower risks especially in emergency conditions when it is not possible to perform any preoperative evaluation.
authors.affiliation: Department of Chest Diseases. Division of Pneumology and Allergology, "A. Cardarelli" High Speciality Hospital, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Liccardi
authors.forename: A
authors.initials: A
authors.lastname: Salzillo
authors.forename: A
authors.initials: A
authors.lastname: Piccolo
authors.forename: I
authors.initials: I
authors.lastname: De Napoli
authors.forename: G
authors.initials: G
authors.lastname: D'Amato
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects*; D000792:Angiography; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D001986:Bronchial Spasm / Q000209:etiology* / Q000517:prevention & control; D003287:Contrast Media / Q000009:adverse effects*; D004333:Drug Administration Routes; D006801:Humans; D017410:Practice Guidelines as Topic; D012306:Risk
chemical_list: D000893:Anti-Inflammatory Agents; D003287:Contrast Media