Anaesthesia and severe pulmonary disease.

The key to the management of anaesthesia in patients with severe pulmonary disease lies in predicting the requirement for support of ventilation and/or oxygenation in the postoperative period, and the provision of effective pain relief in such a way as to allow the patient to maintain adequate spontaneous ventilation. This in turn depends on understanding the influence of the relevant surgical intervention on the patient's ability to sustain his normal breathing requirements, to breathe deeply, and to cough.