Respiratory Disorders

Abstract Respiratory failure represents a significant source of morbidity in the pregnant population. While a variety of etiologies exists, this group presents a unique challenge to the anesthesiologist. In patients who have airway hyperresponsiveness, tracheal intubation can be a potential trigger for bronchospasm in the perioperative period. β2-Agonists are a mainstay of therapy for bronchospasm treatment, although these medications carry the risk of decreasing uterine tone. By administering β2-agonists locally via aerosolization, their systemic effects can be minimized. Neuraxial anesthesia is often the gold standard for parturients with respiratory disease as it allows the provider to provide adequate analgesia and surgical conditions while minimizing airway manipulation. When neuraxial techniques are not an option, the decision of how to proceed must take into account the risk of aspiration, airway reactivity, uterine tone, and hormonal and physiologic changes during pregnancy.