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Chronic respiratory infections can yield problems for the anaesthetist because of postoperative complications, especially severe bronchitis as a result of retained secretions and airway collapse. Hence, in conditions such as emphysema and bronchiectasis, a short preoperative admission to the chest unit may be helpful. There, a short course of antibiotics, physiotherapy and postural drainage can be undertaken. Investigations such as the spirometric measurement of vital capacity and forced expiratory volume provide a gauge to the patient's ability to expel mucus from the airways postoperatively.
The child with cystic fibrosis and necessitating a general anaesthetic demonstrates a particular problem. Even when well enough to undergo the procedure, they are at risk of picking up a nosocomial infection from the ward. Hence, they are ideally admitted to hospital the night before the operation and discharged as soon as possible afterwards.
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