SUMMARY

Inhaled anesthetics have potent and clinically significant effects on respiratory function. Volatile anesthetics reduce bronchial smooth muscle tone, adversely affect mucociliary function, and dilate pulmonary vasculature. Volatile anesthetics also alter the activity of respiratory sensors, the central nervous system, and muscles of respiration. These actions are mediated by a variety of mechanisms, including indirect actions on afferent, central, and efferent neural pathways, as well as direct actions on the lungs. The depressant effects of these drugs are further enhanced in patients with pulmonary disorders. An understanding of the multifactorial actions of inhaled anesthetics on the respiratory system is critical to the safe delivery of anesthesia.