English

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a systemic disease which has been shown to negatively affect the cardiovascular and autonomic nervous systems. In COPD patients the activity of sympathetic nervous system may be affected by recurrent hypoxemia, hypercapnia, increased intrathoracic pressure swings due to airway obstruction, increased respiratory effort, systemic inflammation, oxidative stress and the use of beta sympathomimetics. These case reports are to emphasize the importance of pre anaesthetic evaluation and risk assessment of COPD patients coming for major surgeries.