Asthma is a chronic inflammatory disorder of the airways characterized by hyperresponsiveness, variable airflow obstruction, and airway remodeling. In the OR, we’re less concerned about chronic control and more focused on acute airway events…namely, bronchospasm.

Bronchospasm during general anesthesia can be insidious. You may see rising peak airway pressures, decreased tidal volumes, wheezing if you’re lucky…and if you’re unlucky…desaturation and hypotension. Time is tissue. That’s when it’s time to get medications like albuterol and epinephrine out of the anesthesia cart.

In today’s episode, Sass and Jeremy discuss the pharmacology of albuterol and epinephrine as they relate to the management of intraoperative bronchospasm. 

References

1. Maddah SA, et al. The Effect of Albuterol Spray on Hypoxia and Bronchospasm in Patients with Chronic Obstructive Pulmonary Disease (COPD) under General Anesthesia: A bouble-Blind Randomized Clinical Trial. Ethiop J Health Sci. 2023;33(3):491-498. 
2. von Ungern-Sternberg BS, et al. Effect of Albuterol Premedication vs Placebo on the Occurrence of Respiratory Adverse Events in Children Undergoing Tonsillectomies: The REACT Randomized Clinical Trial. JAMA Pediatr. 2019;173(6):527-533.

Resources/information discussed in podcast

Get your free copy of The Nurse Anesthesia Crisis Management Checklists at www.thenurseanesthesia.com 

About The Nurse Anesthesia

We are building a commUNITY of learning in anesthesia and critical care! We’re educators and clinicians who want to provide valuable information to anyone interested in anesthesia and critical care. We’re here for you!

For anyone who wants to learn or review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you’ve always dreamed of. Let's do this together. It's Go Time!

Sign up for The Nurse Anesthesia Courses

Our CRISIS MANAGEMENT SERIES is currently available! Registered nurses get continuing education credits (CEUs)

Learn more about it at www.thenurseanesthesia.com  

Follow us on Instagram @thenurseanesthesia

If you have an idea for a show, please let us know. 

Legal Disclaimer

The Nurse Anesthesia INC. expressly disclaims any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party.

Music by Alex Grohl