Relationship between pain outcomes and smoking history following video-assisted thoracic surgery for lobectomy: a retrospective study.

Abstract

PurposeThe relationship between chronic smoking history and postoperative pain remains controversial. This study aimed to elucidate this relationship in non-small cell lung cancer (NSCLC) patients who underwent video-assisted thoracic surgery (VATS) lobectomy.Patients and methodsThis retrospective observational study included NSCLC patients treated with VATS lobectomy between January 2011 and July 2017. Demographic and clinical information, including preoperative smoking history, was collected. The primary goal was to investigate the relationship between smoking history and postoperative pain outcomes (oral morphine equivalent [OME] consumption and pain score). Multivariate linear regression analysis was performed, and P<0.05 was considered as statistically significant.ResultsA total of 1,785 patients were included in the final analysis. Multivariate linear regression analysis revealed that total smoking amount (in packs), status as current smoker, and cessation time did not have an association with OME consumption (mg) or pain scores on postoperative days 0–2 (P>0.05). However, patients who had never smoked consumed less morphine equivalent analgesics (mg) on postoperative days 0–2 (coefficient: −17.48, 95% CI [−33.83, −1.13], P=0.036) compared to patients who had a history of smoking.ConclusionPatients who had never smoked had lower opioid analgesics consumption on the days immediately following surgery, while being a current smoker or the total amount of smoking in packs did not affect postoperative pain outcomes after VATS lung lobectomy.