Postoperative Analgesic Requirement in Abstaining Smokers and Non-smokers

Objectives: This study was designed to test the hypothesis that smoking patients who abruptly discontinue smoking require more postoperative analgesics than nonsmokers. Methods: The data of all patients who had received intravenous fentanyl via a patient-controlled analgesia (PCA) device for a year were reviewed. Smokers (n=44) were compared with non-smokers (n=102) with regard to analgesic use during the 24 hours after surgery. Results: No significant differences were observed in the weight-adjusted fentanyl use, the incidence of adverse effects and the pain visual analog scale at the initiation and 24 hours after starting PCA. However, the percentage of patients who received NSAIDs and intravenous morphine was significantly higher in the smokers than in the non-smokers (p=0.01 and 0.03, respectively). Conclusion: Despite the fact that no significant difference in fentanyl consumption was observed, the percentage of patients for whom other analgesics were prescribed was significantly higher in smokers than non-smokers. This result might support the hypothesis that abstaining smokers require more analgesics than non-smokers after surgery. [Introduction] Approximately 25 million Japanese smoke cigarettes and many of them undergo surgery in their lifetime1).