Which anesthetic agent is ideally avoided in asthmatic patients due to potential airway irritation?

Desflurane is ideally avoided in asthmatic patients primarily due to its potential airway irritant properties. Desflurane is a volatile anesthetic that can cause airway irritation, leading to bronchospasm or increased airway resistance, which can exacerbate asthma symptoms. This irritant effect is particularly concerning during induction and maintenance of anesthesia in patients with reactive airways, as it could provoke bronchospasm or heightened airway reactivity.

On the other hand, other agents listed have different profiles: isoflurane is generally considered less irritating to the airway than desflurane, ketamine has been used without significant airway irritation in many cases, and propofol typically does not irritate the airway and is often a preferred choice for patients with asthma. Therefore, the potential for desflurane to irritate the airways makes it a less suitable option for asthmatic patients.