Bronchospasm during anaesthesia. A computer‐aided incidence study of 136 929 patients

Abstract

With the aid of a computer-based anaesthetic record-keeping system, anaesthetics complicated by bronchospasm during anaesthesia at the Karolinska Hospital were retrieved. The incidence of bronchospasm was calculated in groups characterized by various variables. In total, 246 cases of bronchospasm in 156,064 anaesthetics were retrieved. This corresponds to one case in 634 anaesthetics or 1.7 per 1000 patients. High incidence figures were seen in the age group 0-9 years (4.0/1000) when the patients showed a respiratory infection (41.1/1000), a pathological preoperative ECG (24.3/1000), an obstructive lung disease (21.9/1000), were classified as belonging to ASA class III (23.8/1000), if a tracheal intubation was performed (9.1/1000) or a rectal anaesthesia (35.7/1000) was given. In the age group 50-69 years (1.8/1000), high incidence figures were seen when there was an airway obstruction (8.8/1000), an obstructive lung disease (7.7/1000), a previous myocardial infarction (5.4/1000), a bronchoscopy (7.6/1000) or a mediastinoscopy (7.8/1000) was performed. Most of the cases had no history of allergy or asthma recorded in the anaesthetic form. In this series the triggering factor more often seemed to be of mechanical origin. There were no intraoperative deaths.

Prospective assessment of the risk of postoperative pulmonary complications in patients submitted to upper abdominal surgery

“…The high hospital costs imposed by this additional medical care have been described in the literature. 28 This study was designed to evaluate patients undergoing elective upper abdominal surgery, using clinical and spirometric parameters as suggested by previous studies, so as to estimate the probability of PPCs. Before doing this study, we used to assess the prognostic index on the basis of prognostic scores developed in other populations with different backgrounds.…”

Bronchodilator premedication does not decrease respiratory adverse events in pediatric general anesthesia

“…13 Furthermore, the airway resistance increase seen immediately after intubation in adults can be attenuated by bronchodilator administration. 15 Though adverse events during emergence from anesthesia are not common, recent URI does increase their incidence -specifically bronchospasm 1,6,7 and laryngospasm. 8,16 The role of the autonomic nervous system in laryngospasm and bronchospasm suggested a role for bronchodilator administration.…”

“…In this highly selected population of afebrile patients, the results suggest that anesthesiologists may proceed with surgery using specific criteria in the presence of a URI. HE association between a recent upper respiratory tract infection (URI) and respiratory adverse events, such as bronchospasm, laryngospasm, and hemoglobin desaturation during general anesthesia, has been documented both retrospectively [1][2][3][4] and prospectively. [5][6][7][8] This is a common challenge in pediatric anesthesia, since previous studies have shown a 30-40% prevalence of recent URI in an unselected population presenting for elective surgery.…”

The effect of preoperative anxiety on the incidence of perioperative bronchospasm: a prospective observational study

“…This study is valuable in the view that it indicates the bronchospasm caused clinically by stress without using experimental induction methods. Olsson et al found the incidence of bronchospasm and wheezing as 0.17% during a general anesthesia, and they determined laringospasm incidence during general anesthesia as 0.89% in another study they conducted [23]. These retro-specific studies were done on non-asthmatic patients.…”

“…The incidence of bronchospasm may have increased the surgical procedure associated with urethral sphincter. Some previous studies have included all elective surgical procedures that have not evaluated bronchospasm in a specific surgical procedure [23,26]. Moreover; the risks possessed by the patient are also the case.…”