Perioperative respiratory events in smokers and nonsmokers undergoing general anaesthesia.

Full Abstract

BACKGROUND: The prevalence of respiratory diseases in smokers and nonsmokers and the incidence of perioperative respiratory events (PREs) were investigated for patients undergoing general anaesthesia. The aim was to quantify well-known problems and to identify possible new associations between smoking and PREs. METHODS: From July 1992 to December 1994, risk factors, demographic data, and PREs were documented by an automatically readable anaesthetic record (ARAR). PREs were used as defined by the German Society of Anaesthesiology and Intensive Care. RESULTS: Of 26961 subsequent anaesthesias in adults, 7122 (26.4%) were performed in smokers with a prevalence of chronic bronchitis of 23.3% (4.8% in nonsmokers). 1573 PREs occurred in 1397 (5.2%) of all anaesthetics. 459 events concerned intubation problems and problems in technical airway management. 1114 specific respiratory events (SPREs) like re-intubation, laryngospasm, bronchospasm, aspiration, hypoventilation/hypoxaemia and others had a total incidence of 5.5% in smokers and 3.1% in nonsmokers. The relative risk (RR) of SPREs was 1.8 in all smokers, 2.3 in young (16-39 years) smokers, and 6.3 in obese young smokers. The RR of perioperative bronchospasm was 25.7 in young smokers with chronic bronchitis. CONCLUSION: The impact of smoking on perioperative respiratory problems should make anaesthetists take this widespread preoperative condition seriously, particularly in young adults. The presented method of incident reporting (based on a national classification) could contribute to future research in anaesthetic epidemiology.

Author information

Author/s: Schwilk, B (B); Bothner, U (U); Schraag, S (S); Georgieff, M (M);

Affiliation: Department of Anaesthesiology and Intensive Care, University of Ulm, Germany.

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Acta anaesthesiologica Scandinavica (Acta Anaesthesiol Scand), published in DENMARK. (Language: eng)

Reference: 1997-Mar; vol 41 (issue 3) : pp 348-55

Dates: Created 1997/06/27; Completed 1997/06/27; Revised 2006/11/15;

PMID: 9113178, status: MEDLINE (last retrieved date: 2/18/2009)

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