Effect of preoperative smoking cessation on postoperative pain outcomes in elderly patients with high nicotine dependence

Abstract

Objective:To investigate the effect of smoking cessation before surgery on postoperative pain and analgesic consumption after thoracoscopic radical resection of lung cancer in elderly patients with high nicotine dependence.Methods:A total of 107 male patients, ages 60 to 70 years, undergoing elective thoracoscopic radical lung cancer surgery from July 2017 to July 2018 were enrolled into 3 groups: group A (highly nicotine-dependent and discontinued smoking <3 weeks before surgery, n = 36), group B (highly nicotine-dependent and discontinued smoking >3 weeks before surgery, n = 38), and group C (nonsmokers, n = 33). Postoperative sufentanil consumption, visual analog scale (VAS) pain scores at rest and during cough, rescue analgesia, opioid-related adverse events, and patient satisfaction were assessed from 0 to 48 h postoperatively.Results:Patient characteristics were comparable among the 3 groups. Sufentanil consumption and VAS pain scores from postoperative 0 to 48 h were significantly higher in groups A and B than in group C. In addition, group B had lower sufentanil consumption and pain scores than group A. No differences in the need for rescue analgesia, patient satisfaction, or occurrence of postoperative adverse events, including nausea, vomiting, respiratory depression, and oversedation, were observed among the 3 groups.Conclusion:Compared with nonsmokers, highly nicotine-dependent male patients who were deprived of cigarettes experienced more severe pain and required treatment with more sufentanil after thoracoscopic radical lung cancer surgery. Moreover, preoperative smoking cessation at least 3 weeks before surgery led to better postoperative pain outcomes than smoking cessation within 3 weeks of surgery.

Influence of reduction quality on functional outcome and quality of life in treatment of tibial plafond fractures: a retrospective cohort study

“…The negative effect of nicotine consumption on osteogenesis and fracture healing has already been well demonstrated in vitro and in vivo test series [38, 39]. Furthermore, a recent study showed that nicotine consumption influences pain perception and therefore smokers are dependent on significantly more analgesics postoperatively [40]. Other studies reported smoking as a predictive factor for musculoskeletal complaints, defined as having pain and/or stiffness in muscles and joints [41].…”

Association between Postoperative Opioid Requirements and the Duration of Smoking Cessation in Male Smokers after Laparoscopic Distal Gastrectomy with Gastroduodenostomy

“…This nicotine activates both central and peripheral nicotinic acetylcholine receptors [ 9 ], which can enhance the descending inhibitory pain pathway, resulting in a potent analgesic effect even in postoperative pain [ 10 ]. However, available evidence suggests that smoking is clinically associated with high postoperative pain scores and increased perioperative analgesic requirements [ 5 , 11 – 13 ].…”

Influence of reduction quality on functional outcome and quality of life in treatment of tibial plafond fractures: a retrospective cohort study

“…Furthermore, a recent study showed that nicotine consumption influences pain perception and therefore smokers are dependent on significantly more analgesics postoperatively [40]. Other studies reported smoking as a predictive factor for musculoskeletal complaints, defined as having pain and/or stiffness in muscles and joints [41].…”