Effect of smoking on perioperative pathophysiology and anesthesia

Abstract

Background Smoking is common and millions of cigarette smokers require surgery and anesthesia ever year.Many anesthesiologists are not sufficiently aware that smoking in the perioperative period is harmful.Objective To improve anesthetic management and surgical outcomes,the paper review the effect of smoking on perioperative pathophysiology and anesthesia.Content Smoking increases not only the risk of some postoperative complications,including pulmonary,cardiovasular and wound-related complications, but also anesthetic related complications, such as hypoxemia, cough, laryngospasm,bronchospasm,and haemodynamic response to tracheal intubation. Even temporary smoking cessation may reduce the risk of these complications and improve surgical outcome. However,smoking status can be helpful in some area,e.g.,reducing postoperative nausea and vomiting . It is controversial that smoking status can reduce postoperative pain. The mechanism of nicotine's effect on analgesia is not fully understood. Smoking changes the potency of many anesthetic drugs including sedatives,analgesic and neuromuscular blockers. Trend The preoperative smoking cessation is beneficial to surgical patients' short-and long-term outcomes.Anesthesiologists should actively persuade their patients to quit smoking. Key words: Smoking; Perioperative; Anesthesia; Complication; Analgesia