Surgery and Asthma: Taking Precautions for Positive Results!
I’ve had surgery under general anesthetic (also known as “where they put you to sleep”) twice in my life. The first time, an operation on my knee, was before I had asthma. The second time, in 2013, is probably not textbook, because I ended up needing emergency surgery (a super long story with basically zero asthma relevance).
The resident taking care of me simply instructed me to take my inhalers and that was that—they rolled me on a bed through the hospital with the surgery consent forms still in my hand and four inhalers in my lap, and that was that. I may have taken some more Ventolin when I was in the pre-op room but things happened pretty quickly.
Taking precautions before surgery
If you’re having planned surgery, though, your doctor may have you take certain precautions depending on how controlled your asthma is around the time of your surgery. These are things your doctor may mention to you, recommended by the Global Initiative on Asthma (GINA), or that you can ask your doctor about when planning surgery, or at a pre-op(eration) appointment1:
- Your current level of asthma control
- Your medications
- If you have needed oral corticosteroids (prednisone) in the past 6 months
- Your pulmonary function
- If extra or different medicines need to be taken to improve your lung function before surgery, such as a short burst of oral steroids.
- If you have taken prednisone in the last 6 months, whether you will require intravenous (IV) steroids during surgery), and how these doses will be tapered after surgery.
How might asthma put you at increased risk during surgery?
Sometimes, people are really sensitive to the medicines used as anesthetics during surgery—it’s important to let your medical team know if you’ve had a bad reaction to anesthetic in the past. It’s also important to ensure your doctor knows if you are allergic to latex.1
When you are under general anesthetic, a tube will be placed into your airway (specifically, your trachea)—this can cause asthma symptoms; you might also experience low oxygen levels, difficulty coughing effectively, buildup of carbon dioxide in your body from insufficient breathing, and greater risk of acquiring a lung infection.1 If you have severe asthma and/or use steroids regularly, you may be at some greater risks from surgery complications related to your asthma or adrenal function, which can be impaired from steroid use2.
While these complications are scary to read, as long as proper precautions are discussed ahead of time, and taken before, during and after surgery, your asthma will likely remain stable. The length of your surgery may also require administration of some medications during surgery—your medical team will handle this if it is necessary.
It is important that you follow any instructions your doctors give you carefully, to provide the best outcomes when you have your surgery. For me, aside from a weird cough that I think was caused more by the intubation irritating my throat rather than my asthma, I had no real problems related to my asthma, although my surgery was over in less than a half hour—or, I think so, anyways… I was out!
Have you ever gotten "moon face" as a side effect of prednisone?