Smoking and Anaesthesia: Implications during perioperative period

Abstract

There are considerable myths which surround not only about the different terminology used for smoking but also about their possible impact during the perioperative period. The health hazards posed by smokeless tobacco(electronic cigar) is lower compared to tobacco cigarette smoke whereas actually the levels of aldehydes aerosol generated from new-generation devices at high power levels (Electronic cigars) could approach or even exceed the levels found in cigarette smoke. Nicotine has analgesic properties and thus many believe that smoking tobacco or inhaling nicotine only (e.g., smokeless tobacco) may have a similar effect on pain perceptions in the perioperative period. Many others have opined and associated smoking as a protective factor against postoperative nausea and vomiting. However smoking whether active or passive is always a general health problem and when such patients come for surgery possess additional challenges to the anaesthesiologist. This review will give a brief account of who is a smoker and different terminology being described in literature to describe smoking who need to quit smoking before surgery and when how smoking adversely affects the physiology of body and based on the available literature formulate an anaesthetic plan in smokers.