The risk of bronchospasm in asthmatics undergoing general anaesthesia and/or intravascular administration of radiographic contrast media. physiopatology and clinical/functional evaluation
Liccardi, G.; Salzillo, A.; Piccolo, A.; De Napoli, I.; D'Amato, G.
European Annals of Allergy and Clinical Immunology 42(5): 167-173
2010
ISSN/ISBN: 1764-1489 PMID: 21192624 Document Number: 639517
It is well known that patients suffering from bronchial asthma undergoing to surgical procedures requiring general anaesthesia (GA) or the administration of water soluble radiographic contrast media (RCM) experience a risk of potentially severe bronchospasm. Nevertheless, little attention has been devoted on the possible preventive measures to reduce the occurrence of this potentially life-threatening event. It has been shown that the most important risk factor for bronchospasm during GA induction and/or the use of RCM is represented by a high degree of bronchial hyperreactivity with airway instability not adequately controlled by long-term anti-inflammatory treatment. The aim of this review is to underline the need for an accurate clinical and functional evaluation of asthmatics (especially those with a relevant degree of asthma severity) undergoing GA or administration of RCM. Guidelines shared by pulmonologists, allergologists, anesthesiologists and radiologists should be produced in the future for a better evaluation and management of these patients. General practitioner plays an important role in managing asthmatic patients in "Real Life". It is likely that "Real Life"--optimally controlled asthmatics could undergo GA/RCM with lower risks especially in emergency conditions when it is not possible to perform any preoperative evaluation.