Abstract:
Background 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.
Methods 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.
Results 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).
Conclusion 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.
