: Pretreatment with either salbutamol alone or salbutamol combined with methylprednisolone significantly and similarly improves lung function within 1 day. However, only combined salbutamol-methylprednisolone pretreatment decreases the incidence of wheezing after tracheal intubation. Therefore, in patients with bronchial hyperreactivity, preoperative treatment with combined corticosteroids and salbutamol minimizes intubation-evoked bronchoconstriction much more effectively than the inhaled beta2-sympathomimetic salbutamol alone.

Both doctors and patients need to be well informed about the hazards of intraocular gas application as good communication may prevent complications. If in doubt, the anesthesiologist should avoid nitrous oxide, in particular in the unconscious patient.

BackgroundObstructive sleep apnea (OSA) is a risk factor for perioperative complications but data on anesthesia regimen are scarce.MethodsIn patients with established or strongly suspected OSA, we assessed in a prospective, randomized design the effects on nocturnal apnea-hypopnea-index (AHI) and oxygen saturation (SpO2) of propofol/remifentanil or sevoflurane/remifentanil based anesthesia. Patients were selected by a history for OSA and / or a positive STOP – questionnaire and received general anesthesia using remifentanil (12 μg/kg/h) combined either with propofol (4-6 mg/kg/h, n = 27) or sevoflurane (approx. 2.2 vol% endtidal, n = 27). AHI and SpO2 were measured during the nights before and after anesthesia.ResultsThere were no differences in AHI between anesthetic regimens nor between the pre- and postoperative nights (propofol: 8.6 h− 1 (median, CI: 3.6–21.9) vs. 7.9 h− 1 (1.8–28.8); p = 0.97; sevoflurane: 3.8 h− 1 (1.8–7.3) vs. 2.9 h− 1 (1.2–9.5); p = 0.85). Postoperative minimum SpO2 (propofol: 80.7% ± 4.6, sevoflurane: 81.6 ± 4.6) did not differ from their respective preoperative baselines (propofol: 79.6% ± 6.5; p = 0.26, sevoflurane: 80.8% ± 5.2; p = 0.39). Even in patients with a preanesthetic AHI > 15, nocturnal AHI remained unchanged postoperatively.ConclusionThus, in a cohort of patients with suspected or confirmed OSA undergoing surgery of moderate duration and severity neither the volatile agent sevoflurane nor the intravenous anesthetic propofol altered nocturnal AHI or oxygen saturation, when combined with the short acting opioid remifentanil.Trial registrationGerman Clinical Trials Register, DRKS00005824 retrospectively registered on 03/12/2014.