Perioperative abstinence from cigarettes: physiologic and clinical consequences.
Chronic exposure to cigarette smoke produces profound changes in physiology that may alter responses to perioperative interventions and contribute to perioperative morbidity. Because of smoke-free policies in healthcare facilities, all smokers undergoing surgery are abstinent from cigarettes for at least some period of time so that all are in various stages of recovery from the effects of smoke. Understanding this recovery process will help perioperative physicians better treat these patients. This review examines current knowledge regarding how both short-term (duration ranging from hours to weeks) and long-term smoking cessation affects selected physiology and pathophysiology of particular relevance to perioperative outcomes and how these changes affect perioperative risk. It will also consider current evidence regarding how nicotine replacement therapy, a valuable adjunct to help patients maintain abstinence, may affect perioperative physiology.
Warner
David O
DO
Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. warner.david@mayo.edu
D000818:Animals; D002320:Cardiovascular Physiological Phenomena / Q000187:drug effects; D006801:Humans; D009424:Nervous System Physiological Phenomena / Q000187:drug effects; D009538:Nicotine / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D019990:Perioperative Care; D012143:Respiratory Physiological Phenomena / Q000187:drug effects; D012306:Risk; D012907:Smoking / Q000503:physiopathology*; D016540:Smoking Cessation; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology; D014945:Wound Healing / Q000502:physiology
D018722:Nicotinic Agonists; D009538:Nicotine