A RANDOMISED STUDY OF POST OPERATIVE PULMONARY COMPLICATIONS AMONG SMOKERS UNDERGOING MAJOR SURGERY UNDER GENERAL ANAESTHESIA.

Dr. Ekramul Haque, Dr. Tushar Kumar, Dr ladhu Lakra, Dr. Usha Suwalka

Abstract


Smoking is considered to be a risk factor for patients undergoing anesthesia and surgery.Tobacco smoking has always been recognized as an important risk factor for perioperative complications. Despite large scale efforts to create awareness about the hazards of tobacco smoking, this habit has greatly increased in recent times.

Aim of this study was to compare the nature and incidence of post operative  pulmonary complications in  smokers undergoing major surgery under general anesthesia to that in non smokers in our hospital. Methods:This is  a randomised comparative study. 50 current smokers determined by self report who smoked ten or more cigarettes per day for more than 5 years were taken into study groups. 50 non smokers were taken in the control group. Smokers were not instructed to quit smoking any time prior to surgery. Standard anesthetic technique was employed on both the groups. Any adverse respiratory adverse events like arterial oxygen desaturation, laryngospasm, bronchospasm,  severe coughing, oral secretions during recovery and any incidence of reintubation, naloxone use or pulmonary edema were recorded in each group. Chi-square test and Fischer exact test have been used as statistical tool to test the significance of events. Results: Samples were matching for age, ASA status and surgical procedures undergone. Smokers had a higher rate of respiratory complications (56% versus 16%). When all the perioperative events were considered it was 6.8 times significantly more in smokers when compared to non smokers with chi-square X2=  17.361 , p<0.001. Oxygen desaturation in smokers was significantly higher than among non smokers (p value = 0.0271). Oral secretions during recovery was also significantly more in smokers (p = 0.012). Interpretation and conclusions: Smoking was associated with increased risk of post operative pulmonary complications in patients undergoing general anesthesia. These findings warrant increased vigilance with such patients coming for anesthesia with efforts to motivate them to avoid or stop smoking completely.


Keywords


Anesthesia,General/ae (adverse effects); Bronchospasm , Comparative study; postoperative, pulse oximetry; Partial pressure; Smoking/pp(pathophysiology); Surgical procedure.

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