The Effects of Cigarette Smoking on Steroidal Muscular Relaxants and Antibiotics Used: A Prospective Cohort Study

Abstract

Background: The impact of cigarette smoking on perianesthesia management is not clear elucidated. This paper studies the impact of long-term cigarette smoking on the dose-response of rocuronium and vecuronium used under general anesthesia and the type of antibiotics used after surgery.Methods: We enrolled 240 participants from a teaching hospital in China in which finally enrolled in 221 participants. 106 participants have a history of long-term cigarette use and 115 participants without a history of smoking. All participants received general anesthesia for various surgeries, and rocuronium was used as the muscular relaxant. The primary outcome was the effective onset time of rocuronium after adjusting for its dose. The secondary outcomes included a recovery index and the time of muscle recovery changing from 25 to 75%.Results: There was no measurable difference in the muscle relaxant onset time, duration of effectiveness, 75% recovery, recovery index, dose of opiates, anesthetics during surgery, or complication rate between smokers or non-smokers. However, the results showed a significant difference in antibiotic use between smokers and non-smokers (chi-squared = 13.695, p < 0.001), and a significant difference in the type of antibiotics used (chi-squared = 21.465, p = 0.003). Smokers had a significantly higher rate of cefathiamidine use.Conclusion: Smoking cigarettes had no effect on muscle relaxants used under general anesthesia, but patients who had a history of smoking were more likely to receive antibiotics after surgery.Clinical Trial Registration:http://www.chictr.org.cn/index.aspx, identifier ChiCTR-OIC-16009157.

The Effect of Smoking on The Pharmacodynamics of Rocuronium Bromide in Total Intravenous Anesthesia

“…Sigara içen ve içmeyen hastalarda rokuronyum bromürün etkisinin değerlendirildiği, anestezi idamesinde inhalasyon ajanı olarak sevofluran kullanılan bir çalışmada ise sigara içen grupta rokuronyum bromürün blok başlama zamanı, T1'in %25 olması ve T1'in %25'ten %75'e yükselme süresi sigara içmeyen gruptan daha kısa bulunmuştur (12). Uzun süreli sigara içen ve içmeyen hastalarda, TİVA ile genel anestezi altında roküronyum bromürün etki başlangıç zamanının, derlenme indeksinin ve T1'in %25'ten %75'e değişen iyileşme süresinin değerlendirildiği bir çalışmada ise bu değişkenler bakımından fark gözlemlenmemiştir (13). Anestezi idamesinde TİVA kullanılan hastalardaki sonuçların çalışmamızdaki sonuçlar ile benzer olduğu gözlemlenmiştir.…”

Smoking cessation policy and treatments derived from the protective motivation of smokers: a study on graphic health warning labels

“…This study was conducted in China, with more than 300 million smokers (ranked first in the world) (Mak et al, 2020;Liu et al, 2021), but Chinese smokers are not protected by GHWLs. Surprisingly, instead of GHWLs, cigarette packages in China have been well designed with attracting slogans and pictures (Wu et al, 2015).…”