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Ann Pharmacother. 2004 Jun;38(6):949-53. Epub 2004 Apr 27.

Postoperative opiate analgesia requirements of smokers and nonsmokers.

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1
College of Pharmacy, University of Utah, 30 S. 2000 East, Room 258, Salt Lake City, UT 84112-5820, USA. fcreekmore@pharm.utah.edu

Abstract

BACKGROUND:

Smoking cigarettes and other forms of nicotine administration appear to blunt the perception of pain. Abrupt discontinuation of nicotine in nicotine-dependent patients appears to increase the perception of pain. The clinical importance of nicotine's effect on pain perception is not fully understood.

OBJECTIVE:

To determine whether smokers who abruptly discontinue smoking as a result of being hospitalized for coronary artery bypass graft (CABG) require more postoperative opiate analgesics than nonsmokers.

METHODS:

A retrospective review of patients who underwent a CABG was performed. Smokers (n = 20) were compared with nonsmokers (n = 69) with regard to opiate analgesic use during the first 48 hours postoperatively. The use of nonopiate sedatives was also compared between the groups.

RESULTS:

When normalized for weight and body mass index, smokers required 23% and 33%, respectively, more opiate analgesics than did nonsmokers (p = 0.027 and 0.023, respectively). The percentage of patients who received benzodiazepines postoperatively was similar in the 2 groups.

CONCLUSIONS:

In this study, smokers deprived of nicotine required a greater amount of opiates in the first 48 hours after CABG than did nonsmokers. Healthcare providers need to be aware of the potential for increased narcotic requirements among nicotine-deprived smokers. Further study is needed to determine whether nicotine replacement lessens the requirement for postoperative analgesics in smokers.

Comment in

PMID:
15113988
DOI:
10.1345/aph.1D580
[Indexed for MEDLINE]
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