Increase in bronchial smooth muscle tone with resultant closure of small airways. Airway edema develops, causing secretions to build up in the airway.
Symptoms: Wheezing, dyspnea, use of accessory muscles, and tachypnea.
May see increased PIP if pt ventilated
Aspiration, pharyngeal or tracheal suctioning, endotracheal intubation, histamine release secondary to medications, or an allergic response may occur more frequently in patients with asthma or COPD.
Removal of precipitating cause.
Goal: Decrease airway irritability and promote bronchodilation.
Medications are beta-2 agonists, such as albuterol (Proventil, Ventolin), salmeterol, and terbutaline.
Epinephrine for life-threatening conditions.
Atropine or glycopyrrolate have been used to decrease secretions and steroids in case of underlying inflammatory disease
Deepen the anesthetic level
100 % O2
Beta-2-agonist
Epinephrine IV or SQ
IV corticoids 2-4 mg/kg
Consider aminophylline drip for long-term post-op mechanical ventilation
If bronchospasm does not resolve, check for kinking of ETT, secretions, overinflated balloon, bronchial intubation, active expiratory efforts, pulmonary edema or embolism, and pneumothorax.