The Decreasing Hazard of Surgical Procedures on Patients with Asthma

¹ Section of Medicine, Mayo Clinic and Mayo Foundation.
² Fellow in Medicine, Mayo Foundation, Rochester, Minnesota.

In a series of 153 patients with asthma who underwent major surgical procedures at the Mayo Clinic from January, 1950, through December, 1955, there were six (3.9 per cent) who had pulmonary complications after operation. This percentage is significantly less than the 13.2 per cent and 15 per cent respectively observed in two previously reported series from the clinic prior to the widespread use of antibiotics. The decrease is attributed mainly to the optimal control of asthma before and after operation, to the use of antibiotics when indicated, and to the newer steroid therapy. Thus, 96.1 per cent of these patients underwent major surgical procedures without the development of significant postoperative pulmonary complications. It is concluded that the properly prepared asthmatic patient is a good surgical risk.

Pulmonary complications occurred in four of 178 asthmatic patients (2.2 per cent) who underwent minor operations. All the complications consisted of severe asthma and all were associated with bronchoscopy. There was one death in this category.

The mortality rates for the two previously reported series and for the present series of 153 patients who underwent major operations were approximately the same (2.1, 1.4 and 1.3 per cent respectively). It is impossible, however, to compare these rates statistically because of the variety of diseases present other than bronchial asthma.

The majority of complications occurred in those patients with intrinsic asthma of long duration.

No untoward effects were attributed to the anesthetic agents used.