The effect of cigarette consumption on postoperative opioid requirement in patients undergoing laparoscopic cholecystectomy

Abstract

Aim: Nicotine, a substance present in cigarette smoke, exerts its pharmacological effects through the nicotinic acetylcholine receptor on target cells. Stimulation of nicotinic acetylcholine receptor leads to the release of opioids. This study aims to compare postoperative analgesic consumption among individuals in smoker, non-smoker, and former smoker groups who have undergone laparoscopic cholecystectomy. Method: Following approval of the Mersin University Faculty of Medicine Clinical Trials Ethics Committee, a retrospective review was conducted on patients who underwent laparoscopic cholecystectomy between May 2017 and May 2018 at the Department of General Surgery of Mersin University Hospital. The patient information registry system was utilized for data extraction. Inclusion criteria encompassed patients undergoing elective operations, aged over 18 years, and possessing an American Society of Anaesthesiologists score of Group I–III. Patients were categorized into three groups: smokers (Group I), non-smokers (Group II), and former smokers (Group III). Results: The study included a total of 100 patients. When comparing opioid consumption and the smoking status of the patients, it was observed that the total opioid consumption within the first 24 hours postoperative was higher in Group I than in Groups II and III (p<0.05). Conclusion: Smoking negatively affects postoperative pain. We believe healthcare providers should be mindful of the increased postoperative opioid requirements in individuals who were cigarette users but have stopped smoking preoperatively. Consequently, analgesia procedures should be managed accordingly.

Keywords

• Smoking
• postoperative pain
• laparoscopic cholecystectomy

Laparoskopik kolesistektomi operasyonu uygulanan hastalarda sigara tüketiminin postoperatif opioid gereksinimi üzerine etkisi

Abstract

Amaç: Sigara dumanında bulunan maddelerden biri olan nikotin, farmakolojik etkilerini hedef hücreler üzerinde bulunan nikotinik asetilkolin reseptörü üzerinden göstermektedir. Nikotinik asetilkolin reseptörlerindeki uyarılmalar opioid salınmasına neden olmaktadır. Bu çalışmada laparoskopik kolesistektomi operasyonu uygulanmış sigara kullanan, kullanmayan ve sigara kullanmayı bırakmış hasta gruplarında postoperatif analjezik ajan tüketiminin karşılaştırılması amaçlandı. Yöntem: Mersin Üniversitesi Tıp Fakültesi Klinik Çalışmalar Etik Kurulu onayı alındıktan sonra Mersin Üniversitesi Tıp Fakültesi Hastanesi Genel Cerrahi Anabilim Dalı tarafından Mayıs 2017 - Mayıs 2018 tarihleri arasında laparoskopik kolesistektomi operasyonu uygulanmış hastalar, hasta bilgi kayıt sisteminden retrospektif olarak tarandı. Elektif şartlarda opere edilmiş, 18 yaş üstünde, Amerikan Anestezi Derneği Skoru I-III olan hastalar çalışmaya dahil edildi. Hastalar sigara kullanan (Grup I), kullanmayan (Grup II) ve sigara kullanmayı bırakanlar (Grup III) olarak 3 gruba ayrıldı. Bulgular: Araştırmaya toplam 100 hasta dahil edildi. Hastaların opioid tüketimi ile sigara kullanma durumları karşılaştırıldığında; postoperatif 24 saatte toplam opioid tüketiminin Grup I’de, Grup II ve III’e göre daha yüksek olduğu belirlendi (p<0.05). Sonuç: Sigaranın postoperatif ağrı üzerine olumsuz etkisi olduğu belirlenmiştir. Sağlık hizmeti sağlayıcılarının perioperatif sigara kullanımı durdurulan sigara kullanıcılarının postoperatif artan oranda opioid gereksinimlerinin farkında olmaları ve analjezi prosedürlerini buna göre düzenlemeleri gerektiğini düşünmekteyiz.

Keywords

• sigara
• postoperatif ağrı
• laparoskopik kolesitektomi

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