Influence of anaesthesia and analgesia on the control of breathing

In summary, more clinical studies are needed on the interaction of anaesthetics and opioids on the behavioural and chemical control of breathing. The interactions described here are important clinically because they show synergistic effects on resting ventilation and carbon dioxide at relatively low drug concentrations (as would be used in monitored anaesthesia care). At these concentrations, the interaction of opioids and anaesthetics on suppression of somatic and autonomic responses is additive. The interaction between remifentanil and propofol for maintenance of i.v. anaesthesia (using abolition of cardiovascular, autonomic and somatic responses to laryngospcopy, intubation and intra-abdominal surgery) was additive when drug concentrations were in the clinical range, but synergistic when concentrations were greater (propofol >8 μg ml-1).