Anaesthesia in smokers (original) (raw)
Related papers
2019
Background: The link between smoking and complications is well documented across surgical specialities. Hence; the present study was undertaken for assessing Intra-Operative and Post-Operative Complications among Smokers under General Anesthesia. Subjects and Methods: The present study was undertaken in the department of Anaesthesia, Government Medical College, Barmer, Rajasthan, India with aim of assessing Intra-Operative and Post-Operative Complications among Smokers under General Anesthesia. A total of 50 patients were enrolled in the present study. Ethical approval was obtained from institutional ethical committee and written consent was obtained from all the patients after explaining in detail the entire research protocol. Inclusion criteria for the present study included: 1) Current smokers, 2) Patients with current smoking habit from a minimum of 5 years, 3) Patients scheduled to undergo any surgical procedure under general anesthesia. Complete demographic details of all the patients were obtained. Incidence of both intra-operative and postoperative complications in all the patients was recorded. All the results were recorded in Microsoft excel sheet and were analyzed by SPSS software. Results: Intraoperative complications included need for ventilator, heart attack and requirement of intra-operative analgesia. Postoperative complications included impaired wound healing and nausea and vomiting. Conclusion: Smokers are subjects to significant chances of occurrence of intraoperative and postoperative complications.
Perioperative smoking cessation and anesthesia: A review
Journal of Clinical Anesthesia, 1992
for patients undergoing anesthesia. These cardiopulmonary effects are carbon monoxide and nicotine mediated changes in oxygen (OJ delivery and myocardial 0, balance. Smokers also are at increased risk for postoperative pulmonary corn,plications that are secondary to chronic changes in lung function. Smoking-induced acute changes in cardiopulmon ary function can be largely avoided by a brief period of preoperative smoking abstinence. Bringing about a decrease in postoperative pulmonary complications requires a much longer period of preoperative abstinence. Because the perioperative period is in many ways an ideal time to abandon the smoking habit permanently, anesthesiologists, in cooperation with other health professionals, can perhaps play a more active role in facilitating this process.
JAMA Surgery, 2013
The effects of smoking on postoperative outcomes in patients undergoing major surgery are not fully established. The association between smoking and adverse postoperative outcomes has been confirmed. Whether the associations are dose dependent or restricted to patients with smoking-related disease remains to be determined. OBJECTIVE To evaluate the association between current and past smoking on the risk of postoperative mortality and vascular and respiratory events in patients undergoing major surgery. DESIGN Cohort study using the American College of Surgeons National Surgical Quality Improvement Program database. We obtained data on smoking history, perioperative risk factors, and 30-day postoperative outcomes. We assessed the effects of current and past smoking (>1 year prior) on postoperative outcomes after adjustment for potential confounders and effect mediators (eg, cardiovascular disease, chronic obstructive pulmonary disease, and cancer). We also determined whether the effects are dose dependent through analysis of pack-year quintiles. SETTING AND PARTICIPANTS A total of 607 558 adult patients undergoing major surgery in non-Veterans Affairs hospitals across the United States, Canada, Lebanon, and the United Arab Emirates during 2008 and 2009. MAIN OUTCOMES AND MEASURES The primary outcome measure was 30-day postoperative mortality; secondary outcome measures included arterial events (myocardial infarction or cerebrovascular accident), venous events (deep vein thrombosis or pulmonary embolism), and respiratory events (pneumonia, unplanned intubation, or ventilator requirement >48 hours). RESULTS The sample included 125 192 current (20.6%) and 78 763 past (13.0%) smokers. Increased odds of postoperative mortality were noted in current smokers only (odds ratio, 1.17 [95% CI, 1.10-1.24]). When we compared current and past smokers, the adjusted odds ratios were higher in the former for arterial events (1.65 [95% CI, 1.51-1.81] vs 1.20 [1.09-1.31], respectively) and respiratory events (1.45 [1.40-1.51] vs 1.13 [1.08-1.18], respectively). No effects on venous events were observed. The effects of smoking mediated through smoking-related disease were minimal. The increased adjusted odds of mortality in current smokers were evident from a smoking history of less than 10 pack-years, whereas the effects of smoking on arterial and respiratory events were incremental with increased pack-years. CONCLUSIONS AND RELEVANCE Smoking cessation at least 1 year before major surgery abolishes the increased risk of postoperative mortality and decreases the risk of arterial and respiratory events evident in current smokers. These findings should be carried forward to evaluate the value and cost-effectiveness of intervention in this setting. Our study should increase awareness of the detrimental effects of smoking-and the benefits of its cessation-on morbidity and mortality in the surgical setting.
Stopping Smoking Shortly Before Surgery and Postoperative Complications
Archives of Internal Medicine, 2011
Objective: To examine existing smoking studies that compare surgical patients who have recently quit smoking with those who continue to smoke to provide an evidence-based recommendation for front-line staff. Concerns have been expressed that stopping smoking within 8 weeks before surgery may be detrimental to postoperative outcomes. This has generated considerable uncertainty even in health care systems that consider smoking cessation advice in the hospital setting an important priority. Smokers who stop smoking shortly before surgery (recent quitters) have been reported to have worse surgical outcomes than early quitters, but this may indicate only that recent quitting is less beneficial than early quitting, not that it is risky. Design: Systematic review with meta-analysis. Data Sources: British Nursing Index (BNI), The Cochrane Library database, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Medline, Psy-cINFO to May 2010, and reference lists of included studies. Study Selection: Studies were included that allow a comparison of postoperative complications in patients undergoing any type of surgery who stopped smoking within 8 weeks prior to surgery and those who continued to smoke. Data Extraction: Two reviewers independently screened potential studies and assessed their methodologic quality. Data were entered into 3 separate meta-analyses that See Invited Commentary at end of article
Postoperative impact of regular tobacco use, smoking or snuffing, a prospective multi-center study
Acta Anaesthesiologica Scandinavica, 2010
The aim was to study the effects of different tobacco administration routes on pain and post-operative nausea and vomiting (PONV), following three common day surgical procedures: cosmetic breast augmentation (CBA), inguinal hernia repair (IHR) and arthroscopic procedures (AS). We have prospectively investigated the effects of regular tobacco use in ambulatory surgery. Methods: The 355 allocated patients were followed during recovery and the first day at home. Results: Thirty-two percent of the patients used tobacco regularly, 33% of CBA, 27% of IHR and 34% of AS. Pain was well controlled in the post-anesthesia care unit at rest; during ambulation, 37% of all patients reported VAS43. Tobacco use had no impact on early post-operative pain. Post-operative nausea was experienced by 30% of patients during recovery while in hospital. On day 1, 14% experienced nausea. We found a significant reduction of PONV
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2011
The literature was reviewed to determine the risks or benefits of short-term (less than four weeks) smoking cessation on postoperative complications and to derive the minimum duration of preoperative abstinence from smoking required to reduce such complications in adult surgical patients. Source We searched MEDLINE, EMBASE, Cochrane, and other relevant databases for cohort studies and randomized controlled trials that reported postoperative complications (i.e., respiratory, cardiovascular, woundhealing) and mortality in patients who quit smoking within six months of surgery. Using a random effects model, meta-analyses were conducted to compare the relative risks of complications in ex-smokers with varying intervals of smoking cessation vs the risks in current smokers. Principal findings We included 25 studies. Compared with current smokers, the risk of respiratory complications was similar in smokers who quit less than two or two to four weeks before surgery (risk ratio [RR] 1.20; 95% confidence interval [CI] 0.96 to 1.50 vs RR 1.14; CI 0.90 to 1.45, respectively). Smokers who quit more than four and more than eight weeks before surgery had lower risks of respiratory complications than current smokers (RR 0.77; 95% CI 0.61 to 0.96 and RR 0.53; 95% CI 0.37 to 0.76, respectively). For wound-healing complications, the risk was less in smokers who quit more than three to four weeks before surgery than in current smokers (RR 0.69; 95% CI 0.56 to 0.84). Few studies reported cardiovascular complications and there were few deaths. Conclusion At least four weeks of abstinence from smoking reduces respiratory complications, and abstinence of at least three to four weeks reduces wound-healing complications. Short-term (less than four weeks) smoking cessation does not appear to increase or reduce the risk of postoperative respiratory complications. Author contributions Jean Wong was involved in data abstraction, interpretation of data, drafting and revising, and final approval of the article. David Paul Lam was involved in data abstraction and drafting of the article. Amir Abrishami was involved in drafting and revising the article, data analysis, and interpretation of the data. Matthew Chan revised and approved the final version of the article. Frances Chung was involved in the conception and design, revising, and final approval of the article.
Open Journal of Anesthesiology
Aim and Background: It is estimated that up to 20% of patients coming for elective surgery are smokers and carry a risk of perioperative complications. Though smoking cessation and its impact on perioperative outcome are widely investigated worldwide we were unable to find any data in Pakistan. The objective of the study is to determine the impact of the duration of smoking cessation before elective surgery on intraoperative hemodynamics and postoperative pain in Pakistani population. Methods: It was a prospective cohort study conducted at the Aga Khan University Hospital Karachi, Pakistan, for one-year duration. A total of 260 patients scheduled for elective noncardiac surgery under general anaesthesia were recruited. Surgery under regional anaesthesia and minor surgery under general anaesthesia were excluded. Data on self-reported duration of smoking cessation by patients, intraoperative haemodynamics, postoperative pain scores and duration of hospital stay were collected by independently trained data collectors from the preoperative area until the patient is discharged from the hospital. Results: A data from 256 patients were analyzed. On the basis of self-reported duration of preoperative smoking cessation, patients were divided into 4 groups (Group 1: less than 2 days, Group 2: more than 2 days to 7 days, Group 3: more than 7 days to 4 weeks and Group 4: more than 4 weeks). It was found that the longer the duration of cessation of smoking is the less haemodynamic changes and lower postoperative pain scores. Length of stay did not show any difference among all four groups. No major postoperative pulmonary complication was found in any study patient. Conclusions: Duration of cessation of smoking before elective surgery is a significant predictor of intraoperative
Smoker Desaturation during General Anaesthesia: A Case Report
2020
We report a sudden hypoxaemia during intubation and after extubation in patient was smoking few hour before surgery. The cause of his desaturation was not related to secretion in the upper airway but may be due to reduced oxygen tension in the body prior to surgery. We able to secure the airway and prevent prolonged of desaturation by intubating this patient during induction and after extubation. We excluded other cause of desaturation for example secretion, bronchospasm and also airway obstruction inn this case. We conclude that smoking cessation was necessary at long as possible even though in case of emergency to prevent potential hypoxaemia pre intubation and during extubation at the end of operation.
Passive smoke exposure is associated with perioperative adverse effects in children
Journal of Clinical Anesthesia, 2011
Study Objective: To evaluate the frequency of respiratory adverse events during general anesthesia in children passively exposed to cigarette smoke (PSE). Design: Prospective, double blinded, observational study. Setting: Operating room and recovery room of a university hospital. Measurements: Data were collected from 385 children who underwent elective surgery during general anesthesia from June to November, 2008. PSE was identified by using the child's caregivers' information. Respiratory adverse events were recorded during anesthesia and post-anesthesia. Main Results: Technique of anesthesia induction and management, distribution of patients' age, gender, surgical procedures, and perioperative analgesic methods were similar in the PSE and non-PSE groups. Respiratory adverse events were reported in 58 patients (15.1%): 50 patients (21.4%) were in the PSE and 8 patients (5.3%) were in the non-PSE group (P = 0.00). The frequency of laryngospasm during anesthesia (P = 0.03) and hypersecretions in the recovery room (P = 0.00) were significantly increased in the PSE group. Conclusions: Children who are exposed to environmental tobacco smoke and who undergo general anesthesia seem to have an increased risk of respiratory complications in the recovery period rather than during anesthesia.