Smokers are most likely to show a mild, but transient increase in airway resistance following intubation and general anesthesia with which inhaled anesthetic?

Smokers are most likely to show a mild, but transient increase in airway resistance following intubation and general anesthesia with which inhaled anesthetic?

• A. Isoflurane
• B. Sevoflurane
• C. Halothane
• D. Desflurane

Answer: (D)

Airway irritability from inhaled anesthetics varies, and smokers with reactive airways are especially susceptible to reflex bronchospasm when exposed to certain agents. Desflurane is highly pungent and its vapor is very cool, which together provoke airway mucosa irritation and a reflex constriction of the bronchial smooth muscle. In smokers, this can manifest as a mild, transient increase in airway resistance after intubation and during anesthesia because the airways are already more prone to constrict in response to irritants. The effect tends to be short-lived as the anesthetic depth changes and the airway stabilizes. Other agents are less irritating to the airways—sevoflurane is relatively non-irritating and often preferred when airway reactivity is a concern; isoflurane is pungent but generally less irritating than desflurane; halothane is not primarily chosen for airway irritation issues and has other drawbacks.

Airway irritability from inhaled anesthetics varies, and smokers with reactive airways are especially susceptible to reflex bronchospasm when exposed to certain agents. Desflurane is highly pungent and its vapor is very cool, which together provoke airway mucosa irritation and a reflex constriction of the bronchial smooth muscle. In smokers, this can manifest as a mild, transient increase in airway resistance after intubation and during anesthesia because the airways are already more prone to constrict in response to irritants. The effect tends to be short-lived as the anesthetic depth changes and the airway stabilizes.

Other agents are less irritating to the airways—sevoflurane is relatively non-irritating and often preferred when airway reactivity is a concern; isoflurane is pungent but generally less irritating than desflurane; halothane is not primarily chosen for airway irritation issues and has other drawbacks.