Document Detail


The effects of anesthetic drugs and disease on the chemical regulation of ventilation.
MedLine Citation:
PMID:  15949     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The anesthesiologist uses a wide spectrum of drugs, including inhalational general anesthetics, barbiturates, benzodiazepines, narcotics analgesics and their antagonists, and neuromuscular blocking drugs. All of these drugs in sufficient dose impair the ventilatory response to chemical stimuli, and may cause inadequate gas exchange. The effect of depression of ventilatory control depends on the magnitude of depression and the coexistence of functional abnormalities in the respiratory system. The functional abnormalities are the result of preexistent pulmonary disease or other disease processes that impair respiratory function, the anticipated effects of major surgery (e.g., pulmonary resection), and the complications of anesthesia and surgery. From a functional viewpoint, the mechanisms of the effects of these disease processes on ventilatory control are: (1) interference with the neurophysiological control of automatic ventilation; (2) impairment of peripheral or central chemoreceptor function; (3) impairment of respiratory muscle function; (4) increase in the mechanical load to breathing as a result of increased resistance or decreased compliance of the respiratory system; and (5) increase in the ventilatory requirements as a result of ventilation/blood flow maldistribution, metabolic acidosis, or increased metabolic rate. As a result of current trends in the use of multiple drugs and controlled ventilation during anesthesia, the patient is at greatest risk during the early postoperative period in the recovery room. In addition to the functional abnormalities described above, the probability of impaired gas exchange and respiratory failure is increased as a result of impaired metabolism and elimination of drugs as a result of hepatic and renal insufficiency, and acute changes in acidbase status, which alter the ionization and distribution of drugs.
Authors:
E R Kafer; H M Marsh
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  International anesthesiology clinics     Volume:  15     ISSN:  0020-5907     ISO Abbreviation:  Int Anesthesiol Clin     Publication Date:  1977  
Date Detail:
Created Date:  1977-06-22     Completed Date:  1977-06-22     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370760     Medline TA:  Int Anesthesiol Clin     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-38     Citation Subset:  IM; S    
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MeSH Terms
Descriptor/Qualifier:
Anesthetics / pharmacology*
Anoxia / physiopathology
Anti-Anxiety Agents / pharmacology
Autonomic Nervous System / physiology
Barbiturates / pharmacology
Benzodiazepines
Carbon Dioxide / pharmacology
Fentanyl / pharmacology
Halothane / pharmacology
Humans
Hyperthyroidism / physiopathology
Lung Diseases, Obstructive / physiopathology
Meperidine / pharmacology
Methoxyflurane / pharmacology
Morphine / pharmacology
Naloxone / pharmacology
Neuromuscular Blocking Agents / pharmacology
Neuromuscular Diseases / physiopathology
Obesity / physiopathology
Pulmonary Edema / physiopathology
Pulmonary Fibrosis / physiopathology
Respiration* / drug effects
Scoliosis / physiopathology
Chemical
Reg. No./Substance:
0/Anesthetics; 0/Anti-Anxiety Agents; 0/Barbiturates; 0/Neuromuscular Blocking Agents; 124-38-9/Carbon Dioxide; 12794-10-4/Benzodiazepines; 151-67-7/Halothane; 437-38-7/Fentanyl; 465-65-6/Naloxone; 57-27-2/Morphine; 57-42-1/Meperidine; 76-38-0/Methoxyflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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