Most people are aware of the health risks associated with smoking, but did you know smokers have a significantly higher risk of surgical complications during and after surgery than non-smokers? This is especially true when general anesthesia is required during the procedure.
Smoking can significantly increase the risk of surgery and post-surgery complications, including:
- Increased time in recovery, intensive care unit and/or hospital
- Respiratory failure and/or distress
- Heart attack
- Slow wound healing
A 2013 study in the Journal of American Medical Association compared post-surgery risks for smokers, former smokers (who quit at least a year before surgery) and nonsmokers. In comparing smokers with former smokers, researchers found smokers were:
- Seventeen percent more likely to die
- Fifty-three percent more likely to have serious heart and lung complications
Yet, former smokers who had quit at least a year before surgery had no increased risk of death compared to nonsmokers.
Why is Smoking and Surgery a Bad Combination?
- Smoking complicates the use of anesthesia. Smokers’ lungs are compromised and do not work as efficiently as they should; therefore, anesthesiologists have to work harder to keep smokers breathing properly while they are under anesthesia. It is likely medications that relax the muscles in the lungs and widen the airways must be used. It also means the patient may require more post-surgery breathing support such as ventilators or oxygen to help the lungs push oxygen into and remove carbon dioxide from the body.
- The heart must work harder. In general, smoking decreases heart function, making it work harder to do the same job a healthy heart does. Surgery also can put a strain on the heart, especially surgeries of the heart, lungs and vascular systems. This combination puts a smoker at a greater risk for heart problems during or after surgery. The above-mentioned study found smokers had a 77 percent greater risk of heart attack after surgery than non-smokers.
- Wounds take longer to heal. The body requires oxygen to live and to heal. Higher amounts of carbon monoxide in a smoker’s body means less oxygen in the body tissues, resulting in slower healing and increased risk of infection.
Surgery Can Be the Motivation to Kick the Habit
The good news is stopping tobacco just hours, days and weeks before surgery has positive benefits:
- Twelve to 24 hours without smoking decreases the amount of carbon monoxide in the blood, allowing for increased oxygen delivery to the body.
- Two weeks without smoking decreases the secretions in the lungs, which means less coughing and vocal cord spasms, making breathing before, during and after surgery easier.
- A month or two without smoking reduces heart and lung complications by 30 percent.
Many surgeries require a change in diet, lifestyle, etc., to prepare the body for procedure and help ensure optimal outcomes; why not add quitting tobacco to the surgery-prep list? And, since most patients are unable to smoke for hours or days following the procedure, it can be a good time to give up smoking all together and start living a healthier life.
Anesthesiologists Encourage Quitting
The American Society of Anesthesiologists recommends all patients quit for as long as possible prior to surgery. That is why tobacco cessation (quitting) questions and support are part of the pre-surgery process at hospitals and surgery centers. When preparing patients for surgery, healthcare providers utilized the 5As to encourage and help patients quit. They are:
- Ask patients about tobacco use.
- Advise patients about the health risks and surgical complications associated with smoking.
- Assess patients’ willingness to quit tobacco.
- Assist patients with quitting by offering information, tools, support, etc.
- Arrange for follow-up with patients’ primary care provider.
Buy a Boat, Take a Trip
Kicking the habit is not easy, but the benefits are immense. In addition to the health risks, just think of all the time gained to spend with friends and family that previously was spent inhaling away from others. Calculate the amount of money spent on tobacco that can now be used elsewhere and you might find you can afford the vacation or the pontoon boat you’ve been dreaming of.
Need Help to Quit?
If you want to kick the habit, talk to your healthcare provider about the best way for you. There are numerous online resources, local support groups and many employers offer free or low-cost tobacco cessation tools, such as patches and gum. The Arizona Smokers’ Hotline at 800-55-66-222 or ASHLine.org is just a phone call or click away. Why wait? FBN
By Robert E. Wells, Jr., M.D.
Robert E. Wells, Jr., M.D., is an anesthesiologist with Forest Country Anesthesia, joining the practice in 2004. Dr. Wells is one of four anesthesiologists in the practice who specialize in pediatric sedation. He cares for obstetric patients and surgical patients who need any level of anesthesia or sedation – from local anesthetic to regional anesthesia such as a spinal or epidural to full or general sedation. Dr. Wells has been married for 40 years. He has two adult children and five grandchildren, two of which are twins. He and his family made Flagstaff their home in 2004. He is loves to hike, bike and travel, especially with his grandchildren.
To learn more about Dr. Wells and Forest Country Anesthesia, visit ForestCountryAnesthesia.com or call 928-773-2505.