The effect of active smoking and secondhand smoke exposure on early outcomes of ambulatory surgery: a prospective observational study

Purpose Since the hospital stay of patients after ambulatory surgery is short, it is important to determine the factors that may cause problems in the early postoperative period. Among these factors, the effects of which are not fully known are active smoking and secondhand smoke exposure. This study aimed to elucidate how active smoking and secondhand smoke exposure effect early outcomes of ambulatory surgery. Methods A prospective observational study was conducted with 124 patients (42 active smokers, 40 nonsmokers exposed to secondhand smoke and 42 nonsmokers) who underwent ambulatory general surgery. Patients were closely monitored for cardiac and respiratory complications, as well as pain, opioid use, and nausea and vomiting until discharge from the hospital. Results Postoperative complications were observed in 50.8% of the patients. Hypotension was more common in active smokers compared with nonsmokers and nonsmokers exposed to secondhand smoke. Smokers were more likely to require postoperative supplemental oxygen therapy. Pain intensity at 1st and 4th hours after surgery was significantly higher in smokers (p< 0.005). In addition, nonsmokers exposed to secondhand smoke exhibited more severe pain than nonsmokers (p=0.001). There were no statistically significant differences between the groups with regard to opioid consumption. Conclusion Although smoking and secondhand smoke exposure are not associated with serious complications after ambulatory surgery, patients' comfort and the success of ambulatory surgery may be negatively affected due to severe pain associated with smoking and secondhand smoke exposure.