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

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.