Treatment of intraoperative bronchospasm with nebulized isoetharine

Abstract

16 patients in whom bronchospasm developed during general endotracheal anesthesia were studied. The patients were diversified with respect to sex, age, physical status, medical history, surgical procedure, preoperative medication, and anesthetic management. The primary anesthetic used was halothane (9 cases), nitrous oxide-narcotic (6 cases), or enflurane (1 case). Ventilation was controlled at an appropriate fixed volume for each patient by means of a mechanical ventilator. All patients were monitored continuously with a precordial or esophageal stethoscope and an electrocardioscope. Isoetharine, as the commercially available preparation of isoetharine and phenylephrine (Bronkometer), was administered to each patient after the development of bronchospasm. The data obtained in this study support the conclusion that metered-dose nebulization of isoetharine is a useful technique for the treatment of bronchospasm occurring during anesthesia, and that since its use results in few cardiovascular actions, it may be preferable to isoproterenol. The latter particularly may be the case in management of patients who have pre-existing myocardial irritability.