Department of Anesthesiology and Reanimation, Inonu University, Faculty of Medicine, Malatya, Turkey.
J Anesth. 2013 Aug;27(4):569-74. doi: 10.1007/s00540-013-1565-0. Epub 2013 Feb 9.
Although the need for increased postoperative analgesia in smokers has been described, the effect of secondhand smoke on postoperative analgesia requirements has not been studied. We examined the effects of secondhand smoke on fentanyl consumption and postoperative pain.
In this study, 101 patients (American Society of Anesthesiology physical status I and II) who underwent abdominal hysterectomy were divided into 3 groups according to history of exposure to cigarette smoke as per medical records which was retrospectively confirmed by measurement of serum cotinine: smokers (n = 28), nonsmokers (n = 31), and secondhand smokers (n = 32). All patients received propofol-remifentanil total intravenous anesthesia and used fentanyl patient controlled analgesia for postoperative pain. The fentanyl consumption visual analogue scale-pain intensity (VAS-PI) score and side effects were recorded in the postanesthesia care unit (PACU) and at 2, 4, 6, and 24 h after surgery.
Fentanyl consumption at all the evaluation time points was significantly higher in secondhand smokers than in nonsmokers (P < 0.05). However, fentanyl consumption in secondhand smokers was lower than that in smokers in the PACU and at 24 h (P < 0.05). VAS-PI scores during movement and at rest in the PACU and at 4, 6, and 24 h after surgery were higher in secondhand smokers than in nonsmokers (P < 0.05). There were no statistically significant differences between the groups with regard to side effects such as nausea, vomiting, and dizziness (P > 0.05).
Secondhand smoking was associated with increased postoperative fentanyl consumption, and increased VAS-PI scores. These findings may be beneficial for managing postoperative pain in secondhand smokers.
尽管已经描述了吸烟者对术后镇痛需求增加的情况，但二手烟对术后镇痛需求的影响尚未得到研究。我们研究了二手烟对芬太尼消耗和术后疼痛的影响。
本研究中，根据病历中吸烟史将 101 例（美国麻醉医师学会身体状况 I 和 II 级）接受腹部子宫切除术的患者分为 3 组，通过测量血清可替宁来确认，这是通过回顾性确认的：吸烟者（n = 28）、非吸烟者（n = 31）和二手烟暴露者（n = 32）。所有患者均接受丙泊酚-瑞芬太尼全静脉麻醉，并在术后使用芬太尼患者自控镇痛治疗术后疼痛。在麻醉后恢复室（PACU）和术后 2、4、6 和 24 小时记录芬太尼消耗视觉模拟量表疼痛强度（VAS-PI）评分和副作用。
在所有评估时间点，二手烟暴露者的芬太尼消耗均显著高于非吸烟者（P < 0.05）。然而，在 PACU 和 24 小时时，二手烟暴露者的芬太尼消耗低于吸烟者（P < 0.05）。在 PACU 期间以及术后 4、6 和 24 小时，活动和休息时的 VAS-PI 评分在二手烟暴露者中均高于非吸烟者（P < 0.05）。在恶心、呕吐和头晕等副作用方面，各组之间无统计学差异（P > 0.05）。
二手烟暴露与术后芬太尼消耗增加和 VAS-PI 评分增加相关。这些发现可能有助于管理二手烟暴露者的术后疼痛。
