PERIOPERATIVE RESPIRATORY COMPLICATIONS IN PATIENTS WITH ASTHMA

Background: Patients with asthma are thought to be at high risk for pu lmonary complications to develop during the perioperative period, and these complications may lead to serious morbidity, Existing medical re cords were reviewed to determine the frequency of and risk factors for perioperative pulmonary complications in a cohort of residents of Roc hester, Minnesota, who had asthma and who underwent anesthesia and sur gery at the Mayo Clinic in Rochester. Methods: Medical records were re viewed for all residents of Rochester, Minnesota, who were initially d iagnosed as having definite asthma according to strict criteria from 1 January 1964 through 31 December 1983 who subsequently had at least o ne surgical procedure involving a general anesthetic or central neuroa xis block at the Mayo Clinic (n = 706). Results: Bronchospasm was docu mented in the perioperative records of 12 patients [1.7% [exact 95% co nfidence interval, 0.9 to 3%]). Postoperative respiratory failure deve loped in one of these patients. Laryngospasm developed in two addition al patients during operation. All episodes of bronchospasm and laryngo spasm in the immediate perioperative period were treated successfully, No episodes of pneumothorax, pneumonia, or death in the hospital were noted. For univariate analysis, characteristics associated with compl ications included the recent use of antiasthmatic drugs, recent asthma symptoms, and recent therapy in a medical facility for asthma, Patien ts in whom complications developed were significantly older at diagnos is and at surgery. Conclusions: The frequency of perioperative broncho spasm and laryngospasm was surprisingly low in this cohort of persons with asthma, These complications did not lead to severe respiratory ou tcomes in most patients. The frequency of com plications was increased in older patients and in those with active asthma.