The effect of passive exposure to tobacco smoke on perioperative respiratory complications and the duration of recovery / O efeito da exposição passiva à fumaça de tabaco em complicações respiratórias no perioperatório e a duração da recuperação

Abstract Background: The incidence of perioperative respiratory complications and postoperative care unit recovery time investigated in patients with passive tobacco smoke exposure according to the degree of exposure. Methods: Total 270 patients ranging in age from 18 to 60 years with the ASA physical status I or II exposed and not exposed to passive tobacco smoke received general anesthesia for various elective surgical operations evaluated for the study. Patients divided into two groups as exposed and non-exposed to passive tobacco smoke, those exposed to passive smoke are also divided into two groups according to the degree of exposure. Patients taken to the postoperative care unit (PACU) at the end of the operation and monitorized until Modified Aldrete's Scores became 9 and more. Respiratory complications evaluated and recorded in intraoperative and postoperative period. Results: A total of 251 patients were enrolled; 63 (25.1%) patients had airway complications, 11 (4.4%) had complications intraoperatively and 52 (20.7%) patients had complications postoperatively. There has been found significant relation with passive tobacco smoke exposure and high incidences of perioperative and postoperative respiratory complications. The risk of cough, desaturation and hypersecretion complications were found to be increased depending on the degree of exposure. There was significant relation between the degree of passive smoke exposure and the duration of PACU stay. Conclusion: Passive tobacco smoke exposed general anesthesia receiving patients also regarding to the degree of exposure having high rates of perioperative respiratory complications and prolongation of PACU stays when compared with unexposed patients.

Resumo Justificativa: A incidência de complicações respiratórias no perioperatório e o tempo em sala de recuperação pós-anestesia no pós-operatório em pacientes com exposição passiva à fumaça de tabaco foram avaliados de acordo com o grau de exposição. Métodos: Foram avaliados 270 pacientes entre 18-60 anos, estado físico ASA I ou II, passivamente expostos e não expostos à fumaça de tabaco, submetidos à anestesia geral para vários procedimentos cirúrgicos eletivos. Os pacientes foram divididos em dois grupos: passivamente expostos e não expostos à fumaça de tabaco. Aqueles com exposição passiva à fumaça também foram divididos em dois grupos de acordo com o grau de exposição. Os pacientes enviados à sala de recuperação pós-anestesia (SRPA) no fim da cirurgia foram monitorados até atingir 9 ou mais no escore modificado de Aldrete. As complicações respiratórias foram avaliadas e registradas nos períodos intraoperatório e pós-operatório. Resultados: Foram incluídos 251 pacientes, dos quais 63 (25,1%) apresentaram complicações respiratórias, 11 (4,4%) complicações no intraoperatório e 52 (20,7%) complicações no pós-operatório. Houve relação significativa entre a exposição passiva à fumaça de tabaco e a alta incidência de complicações respiratórias no perioperatório e pós-operatório. O risco de complicação como tosse, dessaturação e hipersecreção aumentou de acordo com o grau de exposição. Houve relação significativa entre o grau de exposição passiva à fumaça e o tempo de permanência em SRPA. Conclusão: Os pacientes com exposição passiva à fumaça de tabaco apresentaram altas taxas de complicações respiratórias no perioperatório e prolongamento da permanência em SRPA, em comparação com os pacientes não expostos.

The effect of passive exposure to tobacco smoke on perioperative respiratory complications and the duration of recovery.

BACKGROUND: The incidence of perioperative respiratory complications and postoperative care unit recovery time investigated in patients with passive tobacco smoke exposure according to the degree of exposure. METHODS: Total 270 patients ranging in age from 18 to 60 years with the ASA physical status I or II exposed and not exposed to passive tobacco smoke received general anesthesia for various elective surgical operations evaluated for the study. Patients divided into two groups as exposed and non-exposed to passive tobacco smoke, those exposed to passive smoke are also divided into two groups according to the degree of exposure. Patients taken to the postoperative care unit (PACU) at the end of the operation and monitorized until Modified Aldrete's Scores became 9 and more. Respiratory complications evaluated and recorded in intraoperative and postoperative period. RESULTS: A total of 251 patients were enrolled; 63 (25.1%) patients had airway complications, 11 (4.4%) had complications intraoperatively and 52 (20.7%) patients had complications postoperatively. There has been found significant relation with passive tobacco smoke exposure and high incidences of perioperative and postoperative respiratory complications. The risk of cough, desaturation and hypersecretion complications were found to be increased depending on the degree of exposure. There was significant relation between the degree of passive smoke exposure and the duration of PACU stay. CONCLUSION: Passive tobacco smoke exposed general anesthesia receiving patients also regarding to the degree of exposure having high rates of perioperative respiratory complications and prolongation of PACU stays when compared with unexposed patients.

[The effect of passive exposure to tobacco smoke on perioperative respiratory complications and the duration of recovery]. / O efeito da exposição passiva à fumaça de tabaco em complicações respiratórias no perioperatório e a duração da recuperação.

BACKGROUND: The incidence of perioperative respiratory complications and postoperative care unit recovery time investigated in patients with passive tobacco smoke exposure according to the degree of exposure. METHODS: Total 270 patients ranging in age from 18 to 60 years with the ASA physical status I or II exposed and not exposed to passive tobacco smoke received general anesthesia for various elective surgical operations evaluated for the study. Patients divided into two groups as exposed and non-exposed to passive tobacco smoke, those exposed to passive smoke are also divided into two groups according to the degree of exposure. Patients taken to the postoperative care unit (PACU) at the end of the operation and monitorized until Modified Aldrete's Scores became 9 and more. Respiratory complications evaluated and recorded in intraoperative and postoperative period. RESULTS: A total of 251 patients were enrolled; 63 (25.1%) patients had airway complications, 11 (4.4%) had complications intraoperatively and 52 (20.7%) patients had complications postoperatively. There has been found significant relation with passive tobacco smoke exposure and high incidences of perioperative and postoperative respiratory complications. The risk of cough, desaturation and hypersecretion complications were found to be increased depending on the degree of exposure. There was significant relation between the degree of passive smoke exposure and the duration of PACU stay. CONCLUSION: Passive tobacco smoke exposed general anesthesia receiving patients also regarding to the degree of exposure having high rates of perioperative respiratory complications and prolongation of PACU stays when compared with unexposed patients.

Comparison Between Ultrasonography-Guided Popliteal Sciatic Nerve Block and Spinal Anesthesia for Hallux Valgus Repair.

BACKGROUND: We aimed to compare the efficacy, postoperative pain scores, adverse effects, additional analgesic requirements, and patient satisfaction scores of ultrasonography-guided sciatic nerve block by popliteal approach with spinal anesthesia for hallux valgus correction surgery. METHODS: Sixty patients scheduled for hallux valgus correction surgery were enrolled in this prospective randomized study. Unilateral spinal block was performed on patients in the spinal anesthesia group. Popliteal block group patients received popliteal sciatic nerve block with guidance by both nerve stimulator and ultrasonography. Durations of anesthetic and operative interventions and time until the initiation of surgery were recorded for both groups. Pain magnitude of the patients at the 2nd, 4th, 6th, 12th, and 24th hours following anesthetic interventions were assessed with a visual analog scale (VAS). Adverse effects such as postoperative urinary retention and postdural puncture headache were recorded. Also, patient satisfaction was recorded. Patients were interviewed by phone for anesthetic and operative complications at 72 hours postoperatively. RESULTS: Spinal anesthesia group patients exhibited hypotension, bradycardia, postdural puncture headache, and urinary retention rates of 6.6%, 3.3%, 10%, and 3.3%, respectively. Popliteal block group patients showed none of these adverse effects. Moreover, VAS scores of the patients at the 2nd, 4th, 6th, and 12th hours were significantly lower (P < .001, P = .003, P < .001, P <.001, respectively), postoperative first analgesic requirement times were significantly longer (P < .001), and pain satisfaction scores were significantly higher (P < .001) in the popliteal block group. CONCLUSION: Given the complications related to spinal anesthesia and its insufficiency to maintain analgesia postoperatively, we believe the preferred anesthetic method should be peripheral nerve blocks for hallux valgus correction surgeries. LEVEL OF EVIDENCE: Level I, randomized prospective study.

Impact of obturator nerve block on the short-term recurrence of superficial bladder tumors on the lateral wall.

PURPOSE: The aim of this study was to compare the recurrence rates of patients with bladder tumors on the lateral wall undergoing transurethral resection of bladder tumor(TUR-BT) with or without obturator nerve block (ONB) and to investigate the impact of ONB on the effective tumor resection on the lateral bladder wall. MATERIALS AND METHODS: All patients who underwent TUR-BT under spinal anesthesia within the three-year study period in the study center were reviewed retrospectively. Among these, 68 patients who had been diagnosed with de novo lateral bladder wall tumor and included in low risk group 1n accord with European Organization for Research and Treatment of Cancer (EORTC) classification, undergone complete resection were enrolled into the study. Group 1 (36 patients who underwent TUR-BT with only spinal anesthesia) and group 2 (32 patients who underwent TUR-BT with spinal anesthesia plus ONB) were evaluated with respect to tumor recurrence rates and disease-free time to recurrence, if any. RESULTS: Follow-up periods (range, 19 to 41 months for group 1 and 19 to 39 months for group 2) and overall recurrence rates (group 1, 27.8% and group 2, 18.8%) were also found to be similar. Mean time to recurrence was significantly higher in group 2 (15 ± 5.5 months) than in group 1 (7.8 ± 4.5 months) (P = .009) CONCLUSION: ONB employed in addition to spinal anesthesia in TUR-BT involving the lateral wall can prolong time to recurrence and increase the chance to lengthen disease-free survival in low-risk superficial bladder tumors.