[Anesthetic Management for Patients with Chronic Obstructive Lung Disease].

Abstract

The -most common cause of COPD is cigarette smoking. We use mMRD (Modified British Medical Research Council), CAT (COPD Assessment Test) and GOLD classification of airflow limitation, to evaluate severity of patients with COPD before surgery and create plans to manage their anesthesia. Known COPD is an important patient-related risk factor for postoperative pulmonary complications. Relative risks of postoperative pulmonary complications have ranged from 2.7 to 6.0. Cessation of smoking for four to eight weeks prior to surgery decreases risk of postoperative pulmonary complications. Preoperative instruction regarding inspiratory muscle training may be accomplished. This strategy is time-intensive and potentially expensive. We suggest monitored anesthesia care (MAC), neuraxial anesthesia, or other regional anesthetic tech- niques, but MAC and neuraxial or peripheral regional anesthetic techniques are not suitable for some patients. Non-invasive ventilation (NIV) should be readily available in the postanesthesia care unit to treat respiratory distress in COPD patients.