Inhalational anesthesia: basic pharmacology, end organ effects, and applications in the treatment of status asthmaticus

J Intensive Care Med. 2009 Nov-Dec;24(6):361-71. doi: 10.1177/0885066609344836. Epub 2009 Oct 22.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Anesthesia, Inhalation / methods*
  • Anesthetics, Inhalation / administration & dosage
  • Anesthetics, Inhalation / chemistry
  • Anesthetics, Inhalation / pharmacology*
  • Blood Pressure / drug effects
  • Bronchodilator Agents / administration & dosage
  • Bronchodilator Agents / chemistry
  • Bronchodilator Agents / pharmacology*
  • Critical Care
  • Humans
  • Monitoring, Intraoperative
  • Myocardial Contraction / drug effects
  • Regional Blood Flow / drug effects
  • Status Asthmaticus / drug therapy*
  • Status Asthmaticus / physiopathology

Substances

  • Anesthetics, Inhalation
  • Bronchodilator Agents