Background: Pulmonary conditions such as asthma and chronic obstructive pulmonary
disease (COPD) are common conditions that warrant special consideration in the perioperative period.
When these patients undergo surgical interventions, they have risk of complications such as
bronchospasm, hypoxia, and even postoperative respiratory failure that warrant unplanned intensive
care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are
critical for maintaining stable homeostasis of these chronic conditions.
Objective: To discuss the medications most commonly used to treat pulmonary conditions and to
describe strategies for handling these treatment regimens in the perioperative period.
Method: We conducted an online search of studies and review articles through PubMed and Medline
that addressed pharmacology and perioperative management of pulmonary medications, with
an emphasis on those treating patients with asthma or COPD.
Results: Long-term medications for pulmonary disease are used to slow the progression of these
conditions and reduce the occurrence of acute exacerbations. As such, these medications should be
continued in the perioperative period. If the medications include oral corticosteroids or high-dose
inhaled corticosteroids, stress-dose corticosteroid supplementation may be warranted to avoid adrenal
insufficiency. Inhaled medications can be delivered through the anesthetic circuit, and some
agents may be used to treat exacerbations during surgery.
Conclusion: Patients with chronic pulmonary conditions have risk of perioperative complications.
Their pulmonary treatment regimens should be maintained in the perioperative period to reduce the
risk of such complications.