Effect of second-hand smoking on the incidence of postoperative nausea and vomiting in children after adenoidectomy: a single-centre retrospective study

Abstract

Background: Postoperative nausea and vomiting (PONV) are among the most common postoperative complications affecting children. In adult patients, cigarette smoking significantly reduces the incidence of PONV, although the mechanism underlying this effect is unclear. Here we aimed to investigate whether environmental tobacco smoke exposure influenced the PONV incidence among children. Methods: This monocentric retrospective study included 1348 children (1–15 years of age), who underwent endoscopic adenoidectomy under general anaesthesia, between 22 March 2017 and 26 June 2023. Data for this study were obtained from the patient’s medical records and from a telephone conversation with their parent. Results: Our analysis revealed that the PONV incidence was significantly lower in children exposed to environmental tobacco smoke (ETS), compared to in children who were not passive smokers (13.9% vs 22.1%; p < 0.001). Children of non-smoking parents were at a higher risk of developing PONV (OR: 1.82; 95% CI: 1.31–2.58). Conclusions: Although exposure to ETS has many undesirable consequences, it is also associated with a lower incidence of PONV. Conversely, children without ETS exposure are at a higher risk of PONV development and should receive proactive pharmacological prophylaxis.