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British Journal of Anaesthesia, 2003, Vol. 91, No. 1 40-49
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Review Article

Influence of anaesthesia and analgesia on the control of breathing

A. Dahan* and L. J. Teppema

Department of Anesthesiology, Leiden University Medical Centre (LUMC P5-Q), PO Box 9600, NL-2300 RC Leiden, the Netherlands

Corresponding author. E-mail: a.dahan@lumc.nl

Keywords: complications, hypoxia; model, ventilatory mechanics; receptors, chemoreceptors, carotid body; ventilation; ventilation, gender differences

The first 150 words of the full text of this article appear below.

Most agents used to induce and maintain general anaesthesia or to relieve pain or suppress the responses to pain change the control of breathing drastically. They affect the chemical control of breathing, behavioural control or, most often, both. Chemical or metabolic control of breathing is coupled to metabolism and depends on the chemical composition of arterial blood (pH, PCO2, PO2) and brainstem interstitial fluid (pH, brain tissue PCO2). Chemical control occurs during non-rapid-eye-movement sleep and anaesthesia. Behavioural control adjusts breathing in specific situations such as speech, exercise, pain, arousal and stress. An example of agents that affect both control systems are the volatile halogenated anaesthetics. For example, halothane depresses ventilation by abolishing peripheral drive from the chemoreceptors at the carotid bodies, by general depression of respiratory centres in the central nervous system (CNS), and by the suppression of the function of motor neurones, intercostal . . . [Full Text of this Article]

Assessing the effect of drugs on ventilatory control

Free-radical species and anaesthesia-induced depression of hypoxic drive

Respiratory pharmacodynamics of morphine and its metabolite M6G

Response surface modelling of opioid–anaesthetic interaction on ventilatory control

Alfentanil–sevoflurane interaction
Remifentanil–propofol interaction
Concluding remarks

Acknowledgement


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