Khara Birva, Tobias Joseph D
Department of Anesthesiology, Shree Krishna Hospital, Pramukhswami Medical College and Bhaikaka University, Karamsad, Gujarat, India.
Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
J Asthma Allergy. 2023 Jun 23;16:649-660. doi: 10.2147/JAA.S414026. eCollection 2023.
Asthma remains a common comorbid condition in patients presenting for anesthetic care. As a chronic inflammatory disease of the airway, asthma is known to increase the risk of intraoperative bronchospasm. As the incidence and severity of asthma and other chronic respiratory conditions that alter airway reactivity is increasing, a greater number of patients at risk for perioperative bronchospasm are presenting for anesthetic care. As bronchospasm remains one of the more common intraoperative adverse events, recognizing and mitigating preoperative risk factors and having a pre-determined treatment algorithm for acute events are essential to ensuring effective resolution of this intraoperative emergency. The following article reviews the perioperative care of pediatric patients with asthma, discusses modifiable risk factors for intraoperative bronchospasm, and outlines the differential diagnosis of intraoperative wheezing. Additionally, a treatment algorithm for intraoperative bronchospasm is suggested.
哮喘仍然是接受麻醉护理的患者中常见的合并症。作为一种气道慢性炎症性疾病，哮喘会增加术中支气管痉挛的风险。随着哮喘及其他改变气道反应性的慢性呼吸道疾病的发病率和严重程度不断上升，越来越多有围手术期支气管痉挛风险的患者前来接受麻醉护理。由于支气管痉挛仍然是较常见的术中不良事件之一，识别和减轻术前风险因素以及制定针对急性事件的预先确定的治疗方案对于确保有效解决这种术中紧急情况至关重要。以下文章回顾了小儿哮喘患者的围手术期护理，讨论了术中支气管痉挛的可改变风险因素，并概述了术中哮鸣的鉴别诊断。此外，还提出了术中支气管痉挛的治疗方案。
