• Intraoperative bronchospasm should be first treated by confirming that there is no mechanical obstruction of the tracheal tube, tube placement is correct and adequate depth of anesthesia is present. The initial treatment consists of the administration of a beta-agonist such as albuterol. Epinephrine should be reserved for a severe bronchospasm refractory to initial beta-agonist therapy because of the potential for severe adverse effects. Steroids are not helpful in the acute management and muscle paralysis will not improve the situation. Differential diagnosis should also include pneumothorax, pulmonary edema, pulmonary embolus, and pulmonary aspiration.