Smoking and anaesthesia



Does smoking have an impact on anaesthesia?

Smoking not only has harmful effects on general health but can also increase the risk when having anaesthesia and surgery. Smoking is associated with heart disease, peripheral vascular (blood vessel) disease and multiple types of cancer, including lung, throat, and oesophagus (food tube) and bladder cancer. It can also cause emphysema and chronic bronchitis.
ANZCA recognises that tobacco smoking is addictive and can damage both the health of smokers and those passively exposed to tobacco smoke. The College supports all measures to decrease tobacco consumption and involuntary exposure to tobacco smoke including passive smoking.
Nicotine increases the heart rate, heart pumping, blood pressure, and blood vessel narrowing. Some of these adverse effects may improve after 12 to 24 hours of abstinence.
Smokers have an increased production of mucous, which can clog up the airways. They also have increased sensitivity of the airways, which makes the airways more prone to narrowing during anaesthetic. This airway narrowing impedes delivery of oxygen and can be life threatening. This improves one month after smoking is stopped with further improvements up to six months.
Smokers have a decreased ability to carry oxygen in the blood, however ceasing smoking for more than 12 hours greatly improves the ability of the blood to carry oxygen.
There is also evidence of increased respiratory complications during and after general anaesthesia in children exposed to environmental tobacco smoke.
Surgical wound complication rates are higher in smokers, particularly following plastic and reconstructive surgery, bone surgery, bowel surgery and microsurgery. Smoking has adverse effects on the blood flow to tissues that may impair wound healing.
Smoking should not be permitted within 12 hours of surgery.

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