During laproscopic cholecystectomy, patient develops wheezing. What is the next best line of management?
Ref: Ajay Yadav, Short Textbook of Anaesthesia, 1st edition. Page 97Explanation:BRONCHOSPASM DURING ANESTHESIALight anaesthesia in asthmatics can induce bronchospasni.Secretions and noxious stimuli can also induce bronchospasni.Treatment:Good depth of anesthesia.Bronchodilators.Light anaesthesia during Lord's (Anal) stretching and cervical dilatation can initiate parasympathetic overactivity causing laryngospasm, broncho- spasm, bradycardia and cardiac arrest. This is called Breur Lockhgard reflex.The most common cause of asthmatic attack during surgery is inadequate depth of anesthesia. What to be done during an asthmatic attack during anaesthesia?First, deepen die level of anesthesia.Increase Fi02.Patient is under anesthesia and undergoing surgery, so medical interventions such as beta agonist administration is not the first choice of treatment.When the level of anaesthesia is light, the patient may develop bucking, straining or coughing as a result of endotracheal tube in the trachea and then hronchospasm.Other Methods:IV Ketamine: Increases BP, deepens anaesthesia, causes bronchodilation.Beta agoinst nebulization: Causes bronchodilation.
IV ketamine
IV lignocaine
Bronehodialators beta 2 agonist and oxygenation
Deepen plane of anaesthesia
Anaesthesia For Special Situations