Anaesthesia in patients with pre-existing lung disease

作者：Heinke W^*; Reske A; Kaisers U X

来源：Anasthesiologie & Intensivmedizin, 2009, 50: 36-49.

• Restrictive Lung Disease
• Obstructive Lung Disease
• Peri-operative Pulmonary Complication
• Anaesthesia

Peri-operative pulmonary complications are a major cause of morbidity and mortality in patients undergoing surgery. One of the most important risk factors for such complications is pre-existing lung disease. Accordingly, these patients require intensive peri-operative management. The pre-operative clinical evaluation of the patient's condition is essential for risk assessment and the initiation of appropriate additional diagnostic tests. Such further investigations as chest x-ray, spirometry, and blood gas analysis, for example, should be requested only when clinically warranted. The anaesthetic management is dependent on the pathophysiology of the underlying lung disease. In patients with obstructive lung disease, airway management and the choice of anaesthetic are of the utmost importance. In patients with restrictive lung diseases, however, the choice of the anaesthetic appears to be less critical. During the postoperative period, regional anaesthesia providing effective pain control, together with comprehensive pulmonary physiotherapy is important. Provided that patient management makes good use all the strategies available, even patients with significant pre-operative impairment of lung function can be safely conducted through the peri-operative phase.

• 出版日期2009-1