title: The effects of secondhand smoke on postoperative pain and fentanyl consumption.
abstract: BACKGROUND
  Although the need for increased postoperative analgesia in smokers has been described, the effect of secondhand smoke on postoperative analgesia requirements has not been studied. We examined the effects of secondhand smoke on fentanyl consumption and postoperative pain.
  
  
  METHODS
  In this study, 101 patients (American Society of Anesthesiology physical status I and II) who underwent abdominal hysterectomy were divided into 3 groups according to history of exposure to cigarette smoke as per medical records which was retrospectively confirmed by measurement of serum cotinine: smokers (n = 28), nonsmokers (n = 31), and secondhand smokers (n = 32). All patients received propofol-remifentanil total intravenous anesthesia and used fentanyl patient controlled analgesia for postoperative pain. The fentanyl consumption visual analogue scale-pain intensity (VAS-PI) score and side effects were recorded in the postanesthesia care unit (PACU) and at 2, 4, 6, and 24 h after surgery.
  
  
  RESULTS
  Fentanyl consumption at all the evaluation time points was significantly higher in secondhand smokers than in nonsmokers (P < 0.05). However, fentanyl consumption in secondhand smokers was lower than that in smokers in the PACU and at 24 h (P < 0.05). VAS-PI scores during movement and at rest in the PACU and at 4, 6, and 24 h after surgery were higher in secondhand smokers than in nonsmokers (P < 0.05). There were no statistically significant differences between the groups with regard to side effects such as nausea, vomiting, and dizziness (P > 0.05).
  
  
  CONCLUSIONS
  Secondhand smoking was associated with increased postoperative fentanyl consumption, and increased VAS-PI scores. These findings may be beneficial for managing postoperative pain in secondhand smokers.
authors: Department of Anesthesiology and Reanimation, Inonu University, Faculty of Medicine, Malatya, Turkey. dr_mustafasaid@hotmail.com
authors: Mustafa Said
authors: MS
authors: Aydogan
authors: Erdogan
authors: E
authors: Ozturk
authors: Mehmet Ali
authors: MA
authors: Erdogan
authors: Aytac
authors: A
authors: Yucel
authors: Mahmut
authors: M
authors: Durmus
authors: Mehmet Ozcan
authors: MO
authors: Ersoy
authors: Cemil
authors: C
authors: Colak
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000139:chemically induced* / Q000188:drug therapy*; D010880:Piperidines / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D000077208:Remifentanil; D012189:Retrospective Studies; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D014028:Tobacco Smoke Pollution; D000077208:Remifentanil; D005283:Fentanyl; D015742:Propofol
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