The management of anesthesia for asthmatic patients focuses on minimizing airway hyperreactivity and avoiding perioperative bronchospasm. Patients with asthma face an increased risk of respiratory complications, especially during induction, airway manipulation, and emergence from anesthesia. Preoperative Assessment and Optimization

Assessments focus on recent exacerbations, history of ICU admissions, and frequency of rescue inhaler use. Premedication:

The primary goal is to maintain an adequate depth of anesthesia to prevent triggering bronchospasm.

For patients with poorly controlled symptoms or high-risk surgeries (thoracic/abdominal), a 5-day course of oral glucocorticoids is often prescribed.

Surgery should only be performed on patients with well-controlled asthma; unstable asthma or a recent acute attack requires postponement of elective procedures.

Patients are advised to stop smoking at least 6 to 8 weeks before surgery to restore mucociliary clearance. Intraoperative Management

Administration of short-acting $\beta$2-agonists (e.g., salbutamol) shortly before induction is recommended.

Careful evaluation is crucial to determine if elective surgery can safely proceed.