General: The Asthmatic Patient

In this chapter the essential aspects of managing the asthmatic patient before, during, and after surgery are reviewed. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. The case involves a woman with type 2 diabetes mellitus who is scheduled for urgent laparoscopic, possibly open, cholecystectomy. Issues addressed for preoperative evaluation include assessment for whether the patient is optimized for urgent surgery, hemoglobin A1C test, and premedication. Intraoperative topics include induction, selecting a ventilator mode, and managing complications. Postoperative concerns discussed include extubation criteria and management of glucose levels.