Perioperative terapi asma pediatrik

mild reactive airways disease a nebulized beta-2 agonist one to two hours prior to surgery moderate asthma should have their medical regimen advancedin preparation for surgery with optimization of any inhaled antiinflammatory agents and regular use of beta-2 agonist the week prior to surgery. Nebulized beta-2 agonist one to two hours prior to the planned surgical procedure.

 unstable by history, physical examination or pulmonary function determinations, oral corticosteroids should also be given. severe asthma should also have their asthma therapy optimized as above and should be placed on a 5 day course of oral corticosteroid prior to surgery. all cases, nebulized beta-2 agonists one to two hours prior to surgery should be given.

 upper respiratory tract infections within 2 to 6 weeks prior to an elective procedure1620 be given oral corticosteroid for five days before and including the day of surgery

 Oral corticosteroids, when given,were prescribed in a dosage of 1 mg/kgbody weight, daily for an average of five days prior to and the day of surgery

 The pediatric lung is more collapsible,has increased resistance, and has decreased collateral ventilation as compared to the adult lung

Glukokorti Mineralkotikoi Durasi koid d Potensi (jam) Potensi Deksametason

Metilprednisolon Prednison Prednisolon Hidrokortisone Kortisone

25
5 4 4 0.8 0.8

0
0.5 0.8 0.8 1 1

72
36 24 24 8 8

Kortisol

Adrenal insuf
Supresi hipotalamus/pituary/adrenal axis Stres respons menghasilkan hipotensi karena vaskular tone tidak respon Riwayat penggunaan prednisone 5 mg/hari selama 3 minggu