Original Research Article *Corresponding Author: Suresh Singh, Associate Professor, Dept. of Anaesthesia, B.R.D. Medical College, Gorakhpur, Uttar Pradesh, India Email: drsuresh.singh14@gmail.com http://doi.org/10.18231/j.ijca.2019.076 Indian Journal of Clinical Anaesthesia, July-September, 2019;6(3):395-400 395 Available online at www.iponlinejournal.com Journal homepage: www.innovativepublication.com/journal/ijca Haemodynamic changes and oxygen saturation during general anaesthesia in smokers and non-smokers Meenakshi Agarwal 1 , Suresh Singh 2* , Satish Kumar 3 , Shahbaz Ahmad 4 , Santosh Kr. Sharma 5 1 Ex-resident, 2 Associate Professor, 3,4 Professor, 5 Assistant Professor, Dept. of Anaesthesia, B.R.D. Medical College, Gorakhpur, Uttar Pradesh, India Abstract Introduction and Objectives: Smoking and tobacco chewing causes many physiological changes in the body cardiovascular, cancer and pulmonary morbidity and mortality. The aim of this study is to evaluate the effect of smoking and tobacco chewing on cardio-respiratory system during preoperative and postoperative period. Materials and Methods: The present study was conducted on patients of either sex ranging from 18-60 years of ASA (American Society of Anesthesiology) grade I and grade II scheduled for elective surgical procedures at Nehru Hospital, B.R.D. Medical College, Gorakhpur after the permission of ethical committee. Detailed history and physical examination was done. Arterial blood gas analysis was done and partial pressure of oxygen was recorded preoperatively and on postoperative day 1, 2 and 3. Patients were divided into three groups according to smoking and tobacco chewing habits. Statistical analysis was done using SPSS version 16.0 software. t-test, and Mann–Whitney test were applied according to the requirement. The level of significance was fixed at 95%. P < 0.05 was considered statistically significant. Results: The proposed study was done on 50 patients of ASA grade I and II who were scheduled to undergo elective surgical intervention. Out of 50 patients 37 were male and 13 were female in the ratio of 2.84:1. Mean pulse rate was increased in all groups just after intubation and just after extubation but the amplitude of rise was maximum in Group-III. A significant rise in systolic blood pressure was observed in Group-I (control) just after intubation which came to basal value within 5 minutes of intubation. A significant rise in mean arterial blood pressure was observed in Group-I (control) just after intubation which came to basal value within 5 minutes of intubation. Conclusion: Most of the smokers and tobacco chewers had significant reduction in preoperative bedside pulmonary function tests and associated decrease in partial pressure of oxygen. These patients required oxygen inhalation postoperatively to prevent hypoxia. Introduction Cigarette smoking and its consequences comprise a worldwide epidemic and is attributed to at least 20% of all deaths in developed countries. 1 Cigarette smoke contains over 4700 additional chemical compounds other than nicotine. It includes at least 43 carcinogens which collectively generate a very broad range of pathophysiological effects. 2 Failure to quit smoking before elective or emergency surgery is ill judged which can lead to subsequent risk of intraand postoperative complications. 3 Smoking up to the time of any surgery increases cardiac and pulmonary complications, impairs tissue healing, and is associated with more infections and other problems at the surgical site. 3,4 The relative risk of complications after surgery for smokers compared to nonsmoker has been reported to increase from 1.4-fold to 4.3-fold. 5 These adverse effects compromise the intended procedural outcomes and increase the costs of care. The preoperative stage may offer an opportunity for smoking cessation in surgical patients. All available measures must be taken to help patients to stop smoking prior to surgery. It is both accountable and ethical to implement a policy that those unwilling or unable to stop should have low priority for, or be excluded from, certain elective surgical procedures. 6 Nicotine also increases intracellular calcium during ischemia. This may exacerbate myocardial cell damage. 7 In smokers, the plasma concentration of nicotine reaches 15-50 mg/ml. The half life of nicotine is 30-60 minutes. 8 Nicotine is the principal ingredient responsible for tobacco’s addictive character, which acts through the sympatho- adrenergic system causing an increase in heart rate. 9 Smoking and tobacco chewing causes many physiological changes in the body cardiovascular (atherosclerosis, hypertension, coronary artery disease, thromboembolism, peripheral vascular disease), cancer (oral, larynx, esophagus, pancreas, kidney) and pulmonary (chronic obstructive pulmonary disease, lung cancer) morbidity and mortality. Smokes have a high incidence of postoperative Article Info Received: 20 th January, 2019 Accepted: 22 nd April, 2019 Published Online: 22 nd August, 2019 Keywords: Smoking and tobacco, Arterial blood pressure, Pulse rate, Oxygen.