Anesthetic Mechanisms (MB Kelz, Section Editor)

Current Anesthesiology Reports

, Volume 4, Issue 1, pp 67-75

First online:

Sources of Inspiration: A Neurophysiologic Framework for Understanding Anesthetic Effects on Ventilatory Control

  • Maureen E. CzickAffiliated withDepartment of Anesthesiology, University of Connecticut School of MedicineHartford Hospital
  • , Jeffrey C. WaldmanAffiliated withDepartment of Anesthesiology, University of Connecticut School of Medicine
  • , Jeffrey B. GrossAffiliated withDepartment of Anesthesiology, University of Connecticut School of Medicine Email author 


Almost every medication that is presently available to provide sedation, analgesia, or general anesthesia significantly depresses one or more ventilatory control mechanisms. This places patients at risk of developing hypoventilation and hypoxemia during moderate or deep sedation as well as general anesthesia. As the neurophysiologic processes underlying normal ventilatory drive are discovered, new insights into the influence of anesthetics on ventilation have been recognized. More importantly, research into ways to circumvent these effects is underway. For example, drugs such as serotonin agonists and ampakines have been shown to counteract opioid-induced ventilatory depression without reversing the analgesic effect. On the other hand, efforts to identify agents that reverse the respiratory depression associated with propofol and the inhalation anesthetics have been less promising. Until reliable means for reversing drug-induced ventilatory depression are developed, prompt recognition of ventilatory insufficiency and initiation of resuscitative measures remain the keys to patient safety.


Anesthesia Anesthetics Ventilation Breathing Opioids Propofol