Decreased pain tolerance before surgery and increased postoperative narcotic requirements in abstinent tobacco smokers
Decreased pain tolerance before surgery and increased postoperative narcotic requirements in abstinent tobacco smokers
复制标题
戒烟者术前疼痛耐受力下降，术后麻醉剂需求量增加。
DOI：
10.1016/j.addbeh.2017.10.024
复制
发表时间：
2018-03-01
影响因子：
4.4
通讯作者：
Lu, Zhijie
中科院分区：
文献类型：
--
作者：
Shen, Ling;Wei, Kai;Lu, Zhijie
手术前戒烟对疼痛耐受性和术后疼痛感知的临床影响尚不完全清楚。本临床研究调查戒烟对疼痛阈值的影响在围手术期的患者接受hepatic surgery.Methods：我们招募了148例男性患者（68名非吸烟者和80戒烟吸烟者）谁接受了肝切除术，并接受术后患者自控静脉镇痛。术前测试患者对电刺激的疼痛阈值。我们记录了术后前48小时内所需的额外吗啡当量的累积量。术后1 h、6 h、24 h和48 h采用视觉模拟评分法（VAS）评价疼痛强度。此外，按钮按下消费记录的病人自控镇痛（PCA）pump.Results：组没有不同的基线临床特征。与不吸烟者相比，戒烟者在手术前表现出较低的痛阈，并在手术后的前48小时内需要大量的额外吗啡当量。戒烟者也表现出比不吸烟者更严重的术后疼痛。术后并发症，如恶心，呕吐，头晕，镇静，呼吸抑制，并没有显着差异两组之间。结论：在这项研究中，吸烟者剥夺香烟表现出手术前疼痛耐受性下降，需要大量的术后额外的吗啡当量比非吸烟者。卫生保健提供者必须意识到吸烟者对麻醉剂需求增加的可能性。
Introduction The clinical influence of smoking cessation on pain tolerance before surgery and postoperative pain perception is not fully understood. This clinical study investigated the effect of smoking cessation on pain threshold during the perioperative period in patients undergoing hepatic resection.Methods: We enrolled 148 male patients (68 non-smokers and 80 abstinent smokers) who underwent hepatic resection and received postoperative patient-controlled intravenous analgesia. Patients were tested for pre-operative pain thresholds in response to electrical stimuli. We recorded the cumulative amount of extra morphine equivalent required during the first 48 h after surgery. Pain intensity was evaluated at 1 h, 6 h, 24 h and 48 h after surgery using the visual analogue scale (VAS). Additionally, button-pressing consumption was recorded by a patient-controlled analgesia (PCA) pump.Results: The groups did not differ with respect to baseline clinical characteristics. Compared with non-smokers, abstinent smokers exhibited lower pain thresholds before surgery and demanded a larger quantity of extra morphine equivalent during the first 48 h after surgery. Abstinent smokers also exhibited more severe postoperative pain than non-smokers. Postoperative complications, such as nausea, vomiting, dizziness, sedation, and respiratory depression, did not significantly differ between the two groups.Conclusions: In this study, smokers deprived of cigarettes exhibited decreased pain tolerance before surgery and required a larger quantity of postoperative extra morphine equivalent than non-smokers. Health care providers must be aware of the potential for increased narcotic requirements in smokers.