Genel anestezi uygulanan çocuklarda pasif sigara içiciliğinin COHb, PaO2 ve PaCO2 değerlerine ve cerrahi sonrası solunumsal komplikasyonlara etkisi

Abstract

Aim: Exposure to passive smoking is associated with side effects on pulmonary function in children and also a risk factor for adverse outcomes following anesthesia and surgery. The objective of this study was to determine the effect of passive smoking on COHb, arterial oxygen pressure (PaO 2 ) and arterial carbon dioxide pressure (PaCO 2 ) levels and on postoperative adverse respiratory events in children undergoing general anesthesia. Material and Method: One hundred children (1-16 y) undergoing urologic or abdominal surgery with a history of passive smoking from one or both parents and 50 children with no history of exposure to smoking were analyzed for COHb, PaO 2 and PaCO 2 levels during the anesthesia and for postoperative respiratory events. Parents were asked to complete a questionnaire about their smoking habits before surgery. The arterial blood samples were obtained after intubation of the patients. The respiratory symptoms were evaluated during the stay in the recovery room. The study was approved by the ethics committee (2.06.2009-18442). Results: COHb levels were increased significantly in both one parent smoking group (Group E1) 1.306±0.452 % and two parents smoking group 1.396±0.491% (Group E2). Children with no smoking parents (Group H) had significantly lower COHb levels (1.134±0.491%) compared to the other two groups (p=0.011). The lowest PaCO 2 levels were detected in Group H (33.234±4.33 mmHg) which were significantly lower compared to the other two groups (p=0.007). The number of children with asthma was higher in Group E2 (18%) (p=0.006). There was no significant difference between the groups in terms of PaO 2 levels and postoperative respiratory side effects. Bronchial hypersecretion, cough and desaturation were the most common side effects. Conclusions: Our results indicate that children who are passive smokers should be undergone careful preoperative evaluation considering other coexisting risk factors to avoid postoperative complications. (Turk Arch Ped 2012; 47: 202-207)