Epidural anesthesia for patients with bronchial asthma

The choice of epidural anesthesia for patients with bronchial asthma is controversial. We used epidural anesthesia during surgery in 16 cases of asthma. Epidural anesthesia produced by 1% or 2% lidocaine or mepivacaine without epinephrine did not induce asthmatic attack in any patients. After epidural block, general anesthesia was induced with midazolam and vecuronium and endotracheal tube was inserted in 9 patients. Asthmatic attack occurred in two patients. In one patient it occurred by the endotracheal intubation and in another patient during thyroidectomy under nitrous oxide - oxygen - sevoflurane anesthesia, although no attack was observed in 7 patients. Two patients were considered to be in severe state of bronchial asthma and they had been on steroid drug and inhalation therapy before surgery. Both patients recovered soon with antiasthmatic therapy. These results suggest that epidural anesthesia has little or no relevance to asthmatic attack.