Anesthesia can be done safely for many people with COPD or asthma, but the team tries to lower the chance of airway problems, low oxygen, and bronchospasm, which means tightening of the airways. For asthma, the risk is low when it is well controlled, and the key step is knowing how well your asthma is controlled before surgery. For COPD, general anesthesia carries higher risk for bronchospasm, air trapping, and low oxygen, so the team may use regional anesthesia when possible and adjust the breathing machine to allow longer exhalation.

Common steps include:

• Using short-acting bronchodilators, often shortly before anesthesia and intubation, to open the airways.
• Continuing usual asthma medicines through the day of surgery, except theophylline.
• Giving a 5-day course of oral steroids plus a short-acting bronchodilator for some patients with poorly controlled asthma before surgery when possible.
• Choosing agents that are less likely to trigger bronchospasm, such as propofol, ketamine, sevoflurane, or isoflurane, and avoiding desflurane in asthma.
• Monitoring closely during induction, airway handling, and recovery, since these are the times when breathing problems are most likely.

After surgery, the team watches oxygen levels, keeps you hydrated, gives good pain control, and continues your usual breathing medicines. Verify the exact plan with your surgical or anesthesia team in case they want something different for you.