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Inhalational Anesthesia: Basic Pharmacology, End Organ Effects, and Applications in the Treatment of Status Asthmaticus
Joseph D. Tobias, MD*
Vice-Chairman, Department of Anesthesiology
* To whom correspondence should be addressed. E-mail: Tobiasj{at}health.missouri.edu.
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Abstract |
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The potent inhalational anesthetic agents are used on a daily basis to provide intraoperative anesthesia. Given their beneficial effects on airway tone and reactivity, they also have a role in the treatment of status asthmaticus that is refractory to standard therapy. Although generally not of clinical significance, these agents can affect various physiological functions. The potent inhalational anesthetic agents decrease mean arterial pressure and myocardial contractility. The decrease in mean arterial pressure reduces renal and hepatic blood flow. Secondary effects on end-organ function may result from the metabolism of these agents and the release of inorganic fluoride. The following article reviews the history of inhalational anesthesia, the physical structure of the inhalational anesthetic agents, their end-organ effects, reports of their use for the treatment of refractory status asthmaticus in the intensive care unit (ICU) patient, and special considerations for their administration in this setting including equipment for their delivery, scavenging, and monitoring.
First published on October 22, 2009, doi:10.1177/0885066609344836
Journal of Intensive Care Medicine 2009;24:361.
A more recent version of this article appeared on November 1, 2009
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