Which assessments should be included in a preoperative workup for asthma?

Updated: Nov 20, 2020
  • Author: Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Asthma-related complications associated with surgery include acute bronchoconstriction resulting from intubation, impaired cough, hypoxemia, hypercapnia, atelectasis, respiratory tract infection, and exposure to latex. The likelihood of these complications occurring depends on the severity of the underlying asthma, the type of surgery (thoracic and upper abdominal), and the type of anesthesia. [105]

Patients with asthma should have an evaluation before surgery that includes a review of asthma symptoms, medication use (particularly oral systemic corticosteroids for longer than 2 wk in the past 6 mo), and measurement of pulmonary function. If possible, attempts should be made to improve lung function preoperatively to either predicted values or the personal best level. A short course of oral systemic corticosteroids may be necessary to optimize lung function.

If evidence of airflow obstruction (< 80% of baseline values) is present, a brief course of corticosteroids is recommended. Patients who have received oral corticosteroids for an asthma exacerbation in the past 6 months should receive systemic corticosteroids (100 mg hydrocortisone IV q 8 h) in the perioperative period.

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