The implications of tobacco smoking on acute postoperative pain: A prospective observational study

Abstract

Background: The clinical importance of cigarette smoking on acute postoperative pain perception is not fully understood. Methods: To determine whether smokers who underwent major surgery need more postoperative opiate than do nonsmokers.We prospectively enrolled 407 male and 441 female participants who underwent in-hospital surgery. Current-smokers were compared with nonsmokers and past-smokers about opiate use during the first 72 h after surgery. Results: A greater proportion of males had more smoking history than females. The average age of male current-smokers is smaller than both nonsmokers and past-smokers. The surgical type (upper abdomen, lower abdomen, extremities, spine, and others) and duration of surgery have no differences between current-smokers, past-smokers, and nonsmokers. Statistically, the male current-smokers required more opiate analgesics during the first 72 h following surgery compared with the male nonsmokers and past-smokers; furthermore, the male currentsmokers reported higher pain intensity when moving and at rest on day 1 after surgery. Conclusions: In this study, themale currentsmokers required more morphine in the first 72 h after surgery than did the nonsmokers and past-smokers. Furthermore, smoking was more prevalent among the males than the females. Health care providers must be aware of the potential for increased narcotic requirements in male current-smokers.