Anaesthesia in smokers

SummarySmoking increases the risk of postoperative complications. The potentially most serious smoking-related complications are cardiovascular and respiratory events and delayed wound healing and infection. Smokers should have these risks explained in the preoperative visit and lifetime exposure should be calculated. High exposure should signal the need to refer patients for expert management whether or not clinical manifestations of respiratory disease are found. Preoperative abstinence from smoking must be strongly recommended in all situations because it has been shown to reduce postoperative morbidity. The parents of children about to undergo surgery should be warned of the consequences of passive smoking.

► Patients facing surgery are more likely to quit smoking permanently. ► Lifetime exposure should be calculated and patients with high exposure should receive appropriate perioperative management. ► Always advise smokers to quit, no matter how much time remains before the intervention. ► No evidence suggests that short-term smoking cessation before surgery increases postoperative complications. ► Anaesthesiologists can help smokers to quit.