• Dietrich Henzler, Rolf Rossaint, and Ralf Kuhlen.
• Klinik für Anästhesiologie, Universitätsklinikum Aachen, D-52074 Aachen, Germany. mail@d-henzler.de
• Curr Opin Anaesthesiol. 2003 Jun 1; 16 (3): 323-30.

Purpose Of ReviewChronic pulmonary diseases are getting more important in daily anaesthetic practice, because prevalence is increasing and improved anaesthetic techniques have led to the abandonment of previous contraindications to anaesthesia. It is therefore essential for the anaesthetist to be up to date with current clinical concepts and their impact on the conduction of anaesthesia as well as new insights into how to anaesthetise these patients safely.Recent FindingsIf patients are treated adequately, open and minimally invasive operations can be safely performed under regional and general anaesthesia. The management of acute exacerbations remains challenging, and first-line medical treatment should be supported by non-invasive ventilation. In controlled mechanical ventilation, parameters should be set to avoid dynamic hyperinflation.SummaryAssessing the functional status of patients admitted for surgery remains a difficult task, and in patients identified as being at risk by clinical examination additional spirometry and blood gas measurements may be helpful. If there are flow limitations and signs of respiratory failure, the anaesthetist should be highly alarmed and monitor the patient closely and invasively, yet there is no reason to deny any patient a substantially beneficial operation.

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