DISASTER MEDICINE No. 1 •2025

https://doi.org/10.33266/2070-1004-2025-1

Original article

Complications in Smoking Patients in the Immediate Surgical Period: Measures to Reduce their Incidence

Farid Alnasrti Mohammad1, Slepushkin V.D. 2, Ikaev Z.E. 2

Download the article in pdf format

1 Al-Bashir Central Government Hospital, Amman, Jordan

2 North Ossetian State Medical Academy of the Ministry of Health of Russian Federation, Vladikavkaz, Russian Federation

UDC 613.84:616-089.168.1-06-616.001.45

Pp. 41-45

 

Summary. The aim of the study was to determine the frequency of complications associated with residual myoplegia in the early postoperative period in smoking and non-smoking patients and to develop a scheme to reduce their frequency.

Materials and methods of the study. The study included 173 smoking and non-smoking male patients who were divided into groups depending on the use of different doses of neostigmine as a decurarizing agent for inhalation or intravenous anesthesia of the type of total intravenous anesthesia. The degree of recovery of patients was assessed by the Aldrete and PARS scales. Complications in patients on the first day of the early postoperative period were assessed using a scale developed by the authors.

Statistical analysis was performed using the STATISTICA 10.0 program – developer StatScoft.Inc. The data are presented as a median with an interquartile range (IQR). To test the difference between two compared paired samples, the Wilcoxon W-test was used.

Results of the study and their analysis. When using neostigmine for decurarization in the generally accepted dosage of 50 mcg/kg on the first day of the postoperative period in smoking patients, compared to non-smokers, clinically significant complications from the bronchopulmonary and cardiovascular systems, difficult-to-relieve pain in the area of the surgical wound and delirium are more often recorded, requiring constant monitoring by medical personnel.

The use of neostigmine in the maximum permissible dose of 70 mcg/kg leads to a several-fold decrease in postoperative complications in smokers and non-smokers, which is especially important when a large number of patients are admitted to the clinic at the same time.

Keywords: complications, early postoperative period, neostigmine, non-smoking patients, residual myoplegia, smoking patients

For citation: Farid Alnasrti Mohammad, Slepushkin V.D., Ikaev Z.E. Complications in Smoking Patients in the Immediate Surgical Period: Measures to Reduce their Incidence. Meditsina Katastrof = Disaster Medicine. 2025;1:41-45_ (In Russ.). https://doi.org/10.33266/2070-1004-2025-1-41-45

 

REFERENCES

  1. Wyon N., Joensen H., Yamamoto Y., et al. Carotid Body Chemoreceptor Function is Impaired by Verocuronium During Hypoxia. Anesthesiol. 1998;89:141-149.
  2. Berg H., Viby-Magensen J., Roed J., et al. Residual Neuromuscular Block is a Risk Factor for Postoperative Pulmonary Complications: a Prospective, Randomized, and Blinded Study of Postoperative Pulmonary Complications after Atracrium, Verocuronium and Pancurorium. Acta Anaesth Scand. 1997;41:1095-10103.
  3. Murphy G.S. Residual Neuromuscular Blockade: Incidence, Assessment, and Relevance in the Postoperative Period. Minerva Anesthesiol. 2006;72:97-109.
  4. Danilov M.S., Lebedinskiy K.M., Kurapeev I.S. Central Anticholinergic Syndrome after General Anesthesia: Prevention and Treatment with Galantamine. Vestnik Severo-Zapadnogo Gosudarstvennogo Meditsinskogo Universiteta im. I.I. Mechnikova = Bulletin of the North-West State Medical University Named after I.I. Mechnikov. 2018;10;1:43-49.
  5. Guerra J. Smoking Greatly Increases Risk of Complications after Surgery. Geneva, World Health Organisation, 2020. https://www.who.int/item/20-01-2020
  6. Alnashrati M.F.M., Slepoushkin V.D., Ikaev Z. A. Postoperative Period Smoking Patients-What to Expect. Science Education Practice. Deihi.India. 2024;22;68:121-127 DOI: 10.34660/INF.2024.22.68.084
  7. Slepushkin V.D., Zhenilo V.M., Oskanov M.Yu., Zhenilo M.V. Monitoring Tserebral’nykh Funktsiy v Anesteziologii i Intensivnoy Terapii = Monitoring of Cerebral Functions in Anesthesiology and Intensive Care. Vladikavkaz – Rostov-na-Donu – Nazran’ Publ., 2014. 202 p.
  8. Morgan G.E., Mikhail M.S., Murray M.J. Clinical Anesthesiology. Lange Medical Books, 2010. 450 p.
  9. Bestaev G.G., Slepushkin V.D. Miorelaksanty: Segodnya, Zavtra = Muscle Relaxants: Today, Tomorrow. Vladikavkaz Publ., 2019. 125 p.
  10. Calvey T.N., Williams M.B. Principles and Practice of Pharmacology for Anaesthetists. Blackwell Science, 2006. 180 p.
  11. Jae H.P., Dong K.L., Huyn K., et al. The Principles of Presenting Statistical Results Using Figures. Korean J Anesthesiol. 2022;75;20:139-150. doi: 10/4097/kia.21508
  12. Tikhova G.P. Four-Field Table of Frequency – Occam’s Razor in the World of Statistics. Regionarnaya Anesteziya i Lecheniye Ostroy Boli = Regional Anesthesia and Treatment of Acute Pain. 2012;3;6:69–75.
  13. Magomedov M.A., Zabolotskikh I.B. Mioplegiya = Myoplegia. Moscow, Prakticheskaya Meditsina Publ., 2010. 222 p.
  14. Badwaik G. Smoking and Anaesthesia. Indian Society of Anaesthesiologists. 2023;December,17:5. URL: https://www.isanagpur.org/esense/2023/12/17/smoking-and-anaesthesia/
  15. Scarth E., Smith S. Drugs in Anaesthesia and Intensive Care. Oxford, University Press, 2023. 390 p.

 

The material was received 04.10.24; the article after peer review procedure 20.02.25; the Editorial Board accepted the article for publication 13.03.25