ABSTRACT
The pulmonary effects of anesthetics arise from the physiologic alterations in neural and muscular control, changes in pulmo nary vascular and airway tone, and altera tions in ciliary function and lung mechan ics. The direct toxicology of anesthetics on the pulmonary system constitutes a minor area of research because of the clear ab sence of clinical pulmonary toxicity asso ciated with modern anesthetic practice. With the exception of i.v. administration of liquid volatile anesthetics, pulmonary tox icity of anesthetics has been described only in animal models using obsolete agents, fre quently in high doses, and with pharmaco logic manipulation designed to maximize the production of toxic metabolites. This chapter, therefore, focuses on the adverse pulmonary physiologic and pathophysio logic changes associated with anesthesia with regard to pulmonary mechanics, the pulmonary vasculature, airway caliber, di rect anesthetic pulmonary toxicity, airway irritation, ciliary function, and oxygen tox icity.
