The Impact of Smoking on General Anesthesia: A Literature Review
DOI:
https://doi.org/10.12775/QS.2024.16.52526Keywords
cigarette smoking, anesthesia, smoking cessation, perioperativeAbstract
The interplay between smoking and general anesthesia encompasses significant perioperative risks and complications. This comprehensive review evaluates the physiological consequences of smoking that challenge anesthetic management, including its effects on respiratory and cardiovascular system. We also analyse the impact smoking has on the metabolism of medications commonly used during anasthesia. Common complications of general anesthesia exacerbated by smoking are presented. The review elaborates on the Society for Perioperative Assessment and Quality Improvement 2020 guidelines for preoperative smoking cessation, emphasizing the timing and intensity of interventions, the use of pharmacotherapies, and the benefits of a multidisciplinary approach for improving patient outcomes. Findings underscore the importance of early smoking cessation, which reduces respiratory complications. E-cigarettes as a smoking cessation aid are discussed. Lastly, the paper calls for vigilance in the perioperative management of smokers and the integration of cessation initiatives as a potential "teachable moment" for long-term abstinence.
References
Tobacco use declines despite tobacco industry efforts to jeopardize progress https://www.who.int/news/item/16-01-2024-tobacco-use-declines-despite-tobacco-industry-efforts-to-jeopardize-progress [acces 13.06.2024]
Zatoński, W., and Zatoński, M. (2020). Poland as the country with the steepest decline in per capita cigarette consumption in Europe. Tobacco Prevention & Cessation, 6(Supplement), A102. https://doi.org/10.18332/tpc/128479
Wzrasta odsetek Polaków palących papierosyhttps://www.mp.pl/pacjent/pulmonologia/aktualnosci/320660,wzrasta-odsetek-polakow-palacych-papierosy [access 13.06.2024]
Carrick, M. A., Robson, J. M., & Thomas, C. (2018). Smoking and anaesthesia. BJA Education, 19(1), 1-6. https://doi.org/10.1016/j.bjae.2018.09.005
Benowitz, N. L. (2010). Nicotine Addiction. New England Journal of Medicine, 362(24), 2295–2303. doi:10.1056/nejmra0809890
Chen, S., Yang, F., Xu, T., Wang, Y., Zhang, K., Fu, G., & Zhang, W. (2023, January 26). Smoking and coronary artery disease risk in patients with diabetes: A Mendelian randomization study. Frontiers Media, 14. https://doi.org/10.3389/fimmu.2023.891947
Siow, M Y., Zhou, P L., Horn, S R., Poorman, G W., Suré, A., Kim, J., Buckland, A J., Errico, T J., & Passias, P G. (2017, October 1). The Effects of Smoking on Outcomes Following Cervical Decompression. Elsevier BV, 17(10), S248-S249. https://doi.org/10.1016/j.spinee.2017.08.163
Enderes J, Teschke J, von Websky M, Manekeller S, Kalff JC, Glowka TR. Active smokers show ameliorated delayed gastric emptying after pancreatoduodenectomy. BMC Surg. 2021 Jul 31;21(1):316. doi: 10.1186/s12893-021-01311-2.
S. Lazaar, E. Boselli, D. Chassard, B. Allaouchiche, L. Bouvet, Effect of acute cigarette smoking on gastric contents in regular smoker volunteers. A prospective randomized cross-over study, BJA: British Journal of Anaesthesia, Volume 115, Issue 4, October 2015, Pages 590–594, https://doi.org/10.1093/bja/aev264
Wang, Yi-Chiena,b; Wang, Chien-Wuna,b; Wu, Hsiang-Lingc,d; Cata, Juan P.e; Huang, Shih-Yua,b; Wu, Yu-Minga,b; Chen, Jui-Taia,b; Cherng, Yih-Giuna,b; Tai, Ying-Hsuana,b,*. Cigarette smoking, opioid consumption, and pain intensity after major surgery: An observational study. Journal of the Chinese Medical Association 86(4):p 440-448, April 2023. | DOI: 10.1097/JCMA.0000000000000895
Kim, S., Sim, J. H., Kim, Y., Choi, S., Kim, H., & Leem, G. (2020). Association between Postoperative Opioid Requirements and the Duration of Smoking Cessation in Male Smokers after Laparoscopic Distal Gastrectomy with Gastroduodenostomy. Pain Research and Management, 2021(1), 1541748. https://doi.org/10.1155/2021/1541748
Armstrong, April D. MD, MSc, FRCSC*; Hassenbein, Susan E. CCRP*; Black, Sarah MD‡; Hollenbeak, Christopher S. PhD§. Risk Factors for Increased Postoperative Pain and Recommended Orderset for Postoperative Analgesic Usage. The Clinical Journal of Pain 36(11):p 845-851, November 2020. | DOI: 10.1097/AJP.0000000000000876
Zhao S, Chen F, Wang D, Wang H, Han W, Zhang Y. Effect of preoperative smoking cessation on postoperative pain outcomes in elderly patients with high nicotine dependence. Medicine (Baltimore). 2019 Jan;98(3):e14209. doi: 10.1097/MD.0000000000014209
ÖZTÜRK, E., AYDOĞAN, M. S., KARAASLAN, K., DOĞAN, Z., & TOPUZ, U. (2019). Does smoking increase the anesthetic requirement? Turkish Journal of Medical Sciences, 49(5), 1271-1276. https://doi.org/10.3906/sag-1602-57
Lugg, S. T., Tikka, T., Agostini, P. J., Kerr, A., Adams, K., Kalkat, M. S., Steyn, R. S., Rajesh, P. B., Bishay, E., Thickett, D. R., & Naidu, B. (2017). Smoking and timing of cessation on postoperative pulmonary complications after curative-intent lung cancer surgery. Journal of Cardiothoracic Surgery, 12. https://doi.org/10.1186/s13019-017-0614-4
Oh TK, Jeon JH, Lee JM, Kim MS, Kim JH, Lee SJ, et al. Chronic smoking is not associated with increased postoperative opioid use in patients with lung cancer or esophageal cancer. Pain Physician. 2018;21:e49–55.
Jammer I, Wickboldt N, Sander M, Smith A, Schultz MJ, Pelosi P, Leva B, Rhodes A, Hoeft A, Walder B, Chew MS, Pearse RM; European Society of Anaesthesiology (ESA) and the European Society of Intensive Care Medicine (ESICM); European Society of Anaesthesiology; European Society of Intensive Care Medicine. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures. Eur J Anaesthesiol. 2015 Feb;32(2):88-105. doi: 10.1097
A. Miskovic and A. B. Lumb Postoperative pulmonary complications * British Journal of Anaesthesia, 118 (3): 317–34 (2017) doi: 10.1093/bja/aex002
Tupper, H I., & Velotta, J B. (2023, May 1). Expanding clinicians’ armamentarium for regional pain control after thoracic surgery. AME Publishing Company, 15(5), 2359-2362. https://doi.org/10.21037/jtd-23-344
Brodier, E. A., & Cibelli, M. (2021). Postoperative cognitive dysfunction in clinical practice. BJA Education, 21(2), 75-82. https://doi.org/10.1016/j.bjae.2020.10.004
Guay J. General anaesthesia does not contribute to long-term post-operative cognitive dysfunction in adults: A meta-analysis. Indian J Anaesth. 2011 Jul;55(4):358-63. doi: 10.4103/0019-5049.84850. PMID: 22013251; PMCID: PMC3190509.
Yu, Q., Zhu, H., Yang, X., Gong, W., Yu, H., Wu, Y., Dong, L., & Zhu, Q. (2022). Study on painless gastroscopy and POCD of smoking patients under general anesthesia. Ibrain, 8(3), 276-284. https://doi.org/10.1002/ibra.12041
Wang Z, Liu T, Yin C, Li Y, Gao F, Yu L, Wang Q. Electroacupuncture Pretreatment Ameliorates Anesthesia and Surgery-Induced Cognitive Dysfunction via Activation of an α7-nAChR Signal in Aged Rats. Neuropsychiatr Dis Treat. 2021 Aug 10;17:2599-2611. doi: 10.2147/NDT.S322047. PMID: 34413646; PMCID: PMC8370114.
Wang, R., Wang, G., Liu, Y., & Zhang, M. (2019). Preoperative smoking history is associated with decreased risk of early postoperative cognitive dysfunction in patients of advanced age after noncardiac surgery: A prospective observational cohort study. The Journal of International Medical Research, 47(2), 689-701. https://doi.org/10.1177/0300060518808162
Darvall J, Handscombe M, Maat B, So K, Suganthirakumar A, Leslie K. Interpretation of the four risk factors for postoperative nausea and vomiting in the Apfel simplified risk score: an analysis of published studies. Can J Anaesth. 2021 Jul;68(7):1057-1063. English. doi: 10.1007/s12630-021-01974-8. Epub 2021 Mar 15. PMID: 33721198.
Weibel S, Rücker G, Eberhart LH, Pace NL, Hartl HM, Jordan OL, Mayer D, Riemer M, Schaefer MS, Raj D, Backhaus I, Helf A, Schlesinger T, Kienbaum P, Kranke P. Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis. Cochrane Database Syst Rev. 2020 Oct 19;10(10):CD012859. doi: 10.1002/14651858.CD012859.pub2. PMID: 33075160; PMCID: PMC8094506.
Whalen, Francis MD; Sprung, Juraj MD; Burkle, Christopher M. MD; Schroeder, Darrell R. MS; Warner, David O. MD. Recent Smoking Behavior and Postoperative Nausea and Vomiting. Anesthesia & Analgesia 103(1):p 70-75, July 2006. | DOI: 10.1213/01.ane.0000221435.14002.4c
Shaikh SI, Nagarekha D, Hegade G, Marutheesh M. Postoperative nausea and vomiting: A simple yet complex problem. Anesth Essays Res. 2016 Sep-Dec;10(3):388-396. doi: 10.4103/0259-1162.179310
Chekol, W B., & Melesse, D Y. (2020, January 24). Incidence and Associated Factors of Laryngospasm among Pediatric Patients Who Underwent Surgery under General Anesthesia, in University of Gondar Compressive Specialized Hospital, Northwest Ethiopia, 2019: A Cross-Sectional Study. Hindawi Publishing Corporation, 2020, 1-6. https://doi.org/10.1155/2020/3706106
Sibel Seckin Pehlıvan, Ozlem Oz Gergın, Adnan Bayram, Derya Altay, Duran Arslan, Cihangir Biçer, Recep Aksu The effect of passive smoking on the laryngospasm rate in children sedated during the esophagogastroduodenoscopy Saudi Medical Journal Mar 2022, 43 (3) 275-282; DOI: 10.15537/smj.2022.43.3.20210784
Fan Chiang YH, Lee YW, Lam F, Liao CC, Chang CC, Lin CS. Smoking increases the risk of postoperative wound complications: A propensity score-matched cohort study. Int Wound J. 2023 Feb;20(2):391-402. doi: 10.1111/iwj.13887.
Wong, Jean MD*,†; An, Dong BMSc*; Urman, Richard D. MD, MBA‡; Warner, David O. MD§; Tønnesen, Hanne MD, PhD‖,¶; Raveendran, Raviraj MBBS#; Abdullah, Hairil R. MBBS**; Pfeifer, Kurt MD, FACP, SFHM††,‡‡; Maa, John MD§§,‖‖; Finegan, Barry MD¶¶; Li, Emily BScPharm, PharmD##; Webb, Ashley MBBS, MPH***,†††; Edwards, Angela F. MD‡‡‡; Preston, Paul MD§§§; Bentov, Nathalie MD, MA‖‖‖,¶¶¶; Richman, Deborah C. MBChB††,###; Chung, Frances MBBS*. Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement on Perioperative Smoking Cessation. Anesthesia & Analgesia 131(3):p 955-968, September 2020. | DOI: 10.1213/ANE.0000000000004508
Harrogate, S., Barnes, J., Thomas, K., Isted, A., Kunst, G., Gupta, S., Rudd, S., Banerjee, T., Hinchliffe, R., & Mouton, R. (2023). Peri‐operative tobacco cessation interventions: A systematic review and meta‐analysis. Anaesthesia, 78(11), 1393-1408. https://doi.org/10.1111/anae.16120
Hartmann-Boyce J, Lindson N, Butler AR, McRobbie H, Bullen C, Begh R, Theodoulou A, Notley C, Rigotti NA, Turner T, Fanshawe TR, Hajek P. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2022 Nov 17;11(11):CD010216. doi: 10.1002/14651858.CD010216.pub7. Update in: Cochrane Database Syst Rev. 2024 Jan 8;1:CD010216. doi: 10.1002/14651858.
Yousefzadeh, Amir MD*; Chung, Frances MD, FRCPC*; Wong, David T. MD, FRCPC*; Warner, David O. MD†; Wong, Jean MD, FRCPC*. Smoking Cessation: The Role of the Anesthesiologist. Anesthesia & Analgesia 122(5):p 1311-1320, May 2016. | DOI: 10.1213/ANE.0000000000001170
Lee, Susan M. MD, FRCPC; Landry, Jennifer MD, FRCPC; Jones, Philip M. MD, FRCPC, MSc (Clinical Trials); Buhrmann, Ozzie BScPhm, RPh; Morley-Forster, Patricia MD, FRCPC. Long-Term Quit Rates After a Perioperative Smoking Cessation Randomized Controlled Trial. Anesthesia & Analgesia 120(3):p 582-587, March 2015. | DOI: 10.1213/ANE.0000000000000555
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