title: Increased respiratory symptoms following surgery in children exposed to environmental tobacco smoke.
abstract: OBJECTIVE
  The aim of this study was to determine if children exposed to environmental tobacco smoke (ETS) via parental smoking (ETS+) developed more respiratory symptoms resulting in longer recovery times following surgical outpatient procedures compared with children of nonsmoking parents (ETS-).
  
  
  METHODS
  One hundred and forty six children (4.9 +/- 3 years) undergoing inguinal hernia repair were prospectively studied. Parental smoking behaviour was determined by survey and urine analysis. Seven respiratory symptoms were evaluated during induction and emergence from anaesthesia and during the recovery room (RR) stay.
  
  
  RESULTS
  Fifty-seven (39%) families admitted a smoking history while 89 (61%) denied it. This strongly correlated with the cotinine/creatinine ratio (Pearson correlation coefficient = 0.76; P = 0.01). ETS exposure was associated with an increased frequency of RR symptoms (ETS+: 56%; ETS-: 31%; P = 0.007).
  
  
  CONCLUSIONS
  In children undergoing general anaesthesia for inguinal hernia repair, ETS exposure was associated with an increased frequency of respiratory symptoms during emergence from anaesthesia and during postoperative recovery.
authors.affiliation: University of Michigan, Department of Surgery, Mott Children's Hospital, Ann Arbor, MI 48109-0245, USA. bobd@umich.edu
authors.forename: Robert A
authors.initials: RA
authors.lastname: Drongowski
authors.forename: Donald
authors.initials: D
authors.lastname: Lee
authors.forename: Paul I
authors.initials: PI
authors.lastname: Reynolds
authors.forename: Shobha
authors.initials: S
authors.lastname: Malviya
authors.forename: Carroll M
authors.initials: CM
authors.lastname: Harmon
authors.forename: James
authors.initials: J
authors.lastname: Geiger
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Lelli
authors.forename: Arnold G
authors.initials: AG
authors.lastname: Coran
mesh_terms: D000768:Anesthesia, General; D002648:Child; D003367:Cotinine / Q000652:urine; D003404:Creatinine / Q000652:urine; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D009538:Nicotine / Q000652:urine; D010290:Parents; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012120:Respiration Disorders / Q000209:etiology*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution; D009538:Nicotine; D003404:Creatinine; D003367:Cotinine