Saraswat Vijay
Department of Anaesthesiology, Apollo Hospitals, Nashik, Maharashtra, India.
Indian J Anaesth. 2015 Sep;59(9):557-64. doi: 10.4103/0019-5049.165850.
The primary task of the lungs is to maintain oxygenation of the blood and eliminate carbon dioxide through the network of capillaries alongside alveoli. This is maintained by utilising ventilatory reserve capacity and by changes in lung mechanics. Induction of anaesthesia impairs pulmonary functions by the loss of consciousness, depression of reflexes, changes in rib cage and haemodynamics. All drugs used during anaesthesia, including inhalational agents, affect pulmonary functions directly by acting on respiratory system or indirectly through their actions on other systems. Volatile anaesthetic agents have more pronounced effects on pulmonary functions compared to intravenous induction agents, leading to hypercarbia and hypoxia. The posture of the patient also leads to major changes in pulmonary functions. Anticholinergics and neuromuscular blocking agents have little effect. Analgesics and sedatives in combination with volatile anaesthetics and induction agents may exacerbate their effects. Since multiple agents are used during anaesthesia, ultimate effect may be different from when used in isolation. Literature search was done using MeSH key words 'anesthesia', 'pulmonary function', 'respiratory system' and 'anesthesia drugs and lungs' in combination in PubMed, Science Direct and Google Scholar filtered by review and research articles sorted by relevance.
肺的主要任务是通过肺泡旁的毛细血管网络维持血液的氧合作用并排出二氧化碳。这通过利用通气储备能力和肺力学的变化来维持。麻醉诱导会因意识丧失、反射抑制、胸廓和血流动力学变化而损害肺功能。麻醉期间使用的所有药物,包括吸入剂,通过作用于呼吸系统直接影响肺功能,或通过对其他系统的作用间接影响肺功能。与静脉诱导剂相比,挥发性麻醉剂对肺功能的影响更为显著,会导致高碳酸血症和低氧血症。患者的体位也会导致肺功能发生重大变化。抗胆碱能药物和神经肌肉阻滞剂影响较小。镇痛药和镇静剂与挥发性麻醉剂及诱导剂联合使用可能会加剧其作用。由于麻醉期间使用多种药物,最终效果可能与单独使用时不同。在PubMed、Science Direct和Google Scholar中使用医学主题词“麻醉”“肺功能”“呼吸系统”和“麻醉药物与肺”进行文献检索,检索结果按综述和研究文章进行筛选,并按相关性排序。