Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942002000600010
Brazilian Journal of Anesthesiology
Clinical Information

Condutas no tratamento do broncoespasmo no peri-operatório

Management of perioperative bronchospasm

Cássio Campello de Menezes; Joaquim Edson Vieira

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Resumo

JUSTIFICATIVA E OBJETIVOS: Anestesiologistas podem se deparar com mais freqüência com pacientes portadores de asma dada a prevalência crescente dessa doença. O objetivo deste estudo foi investigar a diversidade de tratamentos utilizados durante o broncoespasmo no período peri-operatório. MÉTODO: Questionário enviado por correio para uma amostra estratificada originalmente composta de 108 anestesiologistas do estado de São Paulo, através da mala direta da Sociedade de Anestesiologia do Estado de São Paulo (SAESP). Perguntas versaram sobre a estatística individual e tratamento do broncoespasmo, a evolução clínica, a experiência profissional do anestesiologista, bem como sua conduta frente a um paciente portador de infecção de vias aéreas (IVAS). RELATO DO CASO: Setenta e três questionários retornaram após envio de três amostras estratificadas (324 questionários). A incidência de broncoespasmo situou-se em 0,90%. As condutas adotadas foram: corticóides (90,41%), halogenados (68,49%), aminofilina (50,68%), beta2-agonista inalatório (47,95%) e epinefrina (41,10%). A maioria dos anestesiologistas suspenderia a anestesia geral (84,93%) ou a regional (64,38%) quando o paciente apresentasse IVAS. CONCLUSÕES: A diversidade dos tratamentos registrados deve indicar a necessidade da divulgação de protocolos internacionais sobre tratamento e controle da asma, enfatizando os usos distintos dos beta2-agonistas inalatórios e corticóides.

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COMPLICAÇÕES

Abstract

BACKGROUND AND OBJECTIVES: The prevalence of asthma is increasing and anesthesiologists may start seeing this clinical manifestation more often in the perioperative period. This study aimed at investigating different bronchospasm management techniques during anesthesia. METHODS: A questionnaire was mailed to a stratified sample of 108 anesthesiologists from the Anesthesiology Society of State of São Paulo (SAESP). Questions involved individual bronchospasm statistics and management, clinical evolution, professional experience and the management of patients with upper airway infection (UAI). RESULTS: After mailing three stratified samples (324 questionnaires), 73 questionnaires were returned with a reported bronchospasm incidence of 0.90%. Management techniques were: steroids (90.41%), halogenates (68.49%), teophylline (50.68%), inhalational beta2-agonists (47.95%) and epinephrine (41.10%). Most anesthesiologists would discontinue general (84.93%) or regional anesthesia (64,38%) in UAI patients. CONCLUSIONS: The diversity of reported treatments indicate the need for spreading international protocols on asthma treatment and control, emphasizing the specific use of inhalational beta2- agonists and steroids.

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COMPLICATIONS

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