Does smoking have an influence on postoperative nausea and vomiting?

Abstract

Background Smoking is considered a risk factor not only for anaesthesia, but for general health. On the other hand, it was demonstrated that smoking reduces postoperative nausea and vomiting. In our study, we have investigated this effect in patients undergoing laparoscopic cholecystectomy. Moreover, we have looked to see if there is a relationship between the number of cigarettes smoked daily and the antiemetic effect. Methods 71 patients scheduled for elective laparoscopic cholecystectomy under general anaesthesia were divided into 2 groups: group 1 (n=40) included non-smokers and group 2 (n=31) included the smokers. Each group was randomized for propofol and thiopentone as an induction agent. In addition, the smokers were further divided into heavy smokers, for patients smoking more than 20 cigarettes daily and smokers for patients smoking less than 20 cigarettes daily. The incidence of postoperative nausea and vomiting and the severity of pain (on Visual Analogue Score) were both assessed for the first 24 hours postoperatively. Results Postoperative nausea and vomiting occurred in 31 patients (77.5%) in the non-smokers’ group, as compared with 12 patients (38.7%) in smokers’ group (p<0.05). The mean maximum degree of pain (5,82) was significantly lower in the smokers’ group as compared with non-smokers where this was 2.8 (p<0.05). Conclusions A history of current smoking significantly reduces postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. Smoking also reduced the incidence of postoperative pain. Despite these favorable effects, we would like to emphasize that our study is not intended to promote smoking.