Volatile Agent Asthma — FRCA Final MCQ

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EasyPaediatric AnaesthesiaVolatile Agent AsthmaFRCA Final

A 4-year-old child (18 kg) with a history of asthma is scheduled for adenotonsillectomy. Which volatile anaesthetic agent provides the best bronchodilation?

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Correct answer: D — Sevoflurane

Sevoflurane is the preferred volatile agent in asthmatic patients (especially children) because it provides the best combination of bronchodilation and airway tolerance. Sevoflurane causes dose-dependent bronchial smooth muscle relaxation and is non-irritant to the airways, making it ideal for inhalational induction. Desflurane is irritant to the airways and can cause bronchospasm, coughing, and laryngospasm – it should be AVOIDED in asthmatic patients, particularly during induction. Isoflurane also provides bronchodilation but is more pungent than sevoflurane.

Reference: RCOA – 2023 – Final FRCA curriculum: inhalational agent pharmacology; BTS/SIGN – 2019 – Asthma guidelines