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This review focuses on the epidemiology, the underlying pathophysiology, and perioperative management of children with airway reactivity, including controlled and uncontrolled asthma. It spans from preoperative optimization to optimized intraoperative management, airway management, and ventilation strategies. There are three leading causes for bronchospasm (1) mechanical (eg, airway manipulation), (2) non\u2010immunological anaphylaxis (anaphylactoid reaction), and (3) immunological anaphylaxis. Children with increased airway reactivity may benefit from a premedication with beta\u20102 agonists, non\u2010invasive airway management, and deep removal of airway devices. While desflurane should be avoided in pediatric anesthesia due to an increased risk of bronchospasm, other volatile agents are potent bronchodilators. Propofol is superior in blunting airway reflexes and, therefore, well suited for anesthesia induction in children with increased airway reactivity.<\/jats:p>","DOI":"10.1111\/pan.14373","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T08:51:52Z","timestamp":1639039912000},"page":"148-155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Anesthetic considerations in children with asthma"],"prefix":"10.1111","volume":"32","author":[{"given":"Adrian","family":"Regli","sequence":"first","affiliation":[{"name":"Intensive Care Unit Fiona Stanley Hospital Perth Western Australia Australia"},{"name":"School of Human Sciences The University of Western Australia Perth Western Australia Australia"},{"name":"Medical School The University of Notre Dame Australia Fremantle Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8418-5572","authenticated-orcid":false,"given":"Aine","family":"Sommerfield","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Management Perth Children\u2019s Hospital Perth Western Australia Australia"},{"name":"Perioperative Medicine Team Telethon Kids Institute Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8043-8541","authenticated-orcid":false,"given":"Britta S.","family":"von Ungern\u2010Sternberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Management Perth Children\u2019s Hospital Perth Western Australia Australia"},{"name":"Perioperative Medicine Team Telethon Kids Institute Perth Western Australia Australia"},{"name":"Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School The University of Western Australia Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,13]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Australian Institute of Health and Welfare (AIHW).Australia\u2019s children. 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