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Intra-operative bronchospasm — FRCA Final MCQ

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ModerateGeneral AnaesthesiaIntra-operative bronchospasmFRCA Final

A 60-year-old man with chronic obstructive pulmonary disease is anaesthetised for femoral-popliteal bypass under general anaesthesia. Shortly after induction peak airway pressure rises, capnography shows an upsloping expiratory phase, auscultation reveals bilateral wheeze, and blood pressure is stable without rash. What is the most likely cause of the complication?

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Correct answer: A — Bronchospasm triggered by airway instrumentation

Bilateral wheeze with an obstructive capnogram after airway instrumentation is most consistent with bronchospasm. Oesophageal intubation would usually produce absent sustained capnography. Anaphylaxis remains a differential but hypotension, rash or cardiovascular collapse would make it more likely. Management includes deepening anaesthesia, 100% oxygen, checking the circuit and tube, and bronchodilator therapy.

Reference: Association of Anaesthetists peri-operative anaphylaxis guidance; RCoA Final FRCA Syllabus 2026