Anesthetic: Triple dose for smokers
Larissa Melville completed her traineeship in the editorial team of . After studying biology at Ludwig Maximilians University and the Technical University of Munich, she first got to know digital media online at Focus and then decided to learn medical journalism from scratch.
More about the experts All content is checked by medical journalists.MunichSmokers pay dearly for the pleasant effects of cigarettes. Because what many do not know: Not only painkillers work worse for them, but also anesthetics.
Cigarette consumption has long been suspected of influencing the effects of drugs and anesthetics. Erdogan Ozturk from Bezmialem Vakif University and his colleagues have investigated how strong the effects on anesthetics and painkillers actually are and to what extent this also affects passive smokers.
To do this, they used the data of 90 women who needed general anesthesia because they had their uterus removed. Before the procedure, the researchers determined the level of cotinine in the participants' blood. This is a metabolite of nicotine that indicates how much tobacco smoke someone has inhaled. Based on the cotinine values, the researchers divided the women into three groups of 30 people each: the active smokers, the passive smokers, i.e. women who did not smoke themselves but were regularly exposed to smoke from others, and finally the non-smokers who hardly used smoke Had come into contact.
Higher doses for smokers and passive smokers
The researchers then recorded the need for narcotics during the procedure. Here smokers were at a strong disadvantage: to induce general anesthesia, they needed 38 percent more of the anesthetic propofol than non-smokers. Passive smokers also needed a higher dose of the anesthetic - 18 percent more dripped into their veins than women who had no contact with tobacco smoke.
In order to ensure the correct depth of anesthesia, the anesthetist who is present monitors, among other things, the functions of the brain. It showed that the increased need for anesthetics among smokers and passive smokers was also maintained during the operation: On average, active smokers received 33 percent more anesthetics and passive smokers 20 percent more anesthetics during the entire procedure - so that they slept deeply enough.
In addition to the anesthetic, the women also received the pain reliever remifentanil during the operation. And here, too, the need of women who were actively or passively exposed to tobacco smoke was higher: smokers received 23 percent and passive smokers 18 percent more remifentanil than non-smokers.
Altered metabolism?
In their study, the researchers only included data from female patients. "The results are in all likelihood transferable to men," Ozturk told Nevertheless, further studies with male subjects are necessary, he adds.
The researchers do not yet know exactly what mechanisms are behind the increased demand. “We suspect that the breakdown of the anesthetics is accelerated by the tobacco components,” says Ozturk. And the faster the drugs are broken down, the more likely they are to lose their effectiveness and have to be given again. "It is also conceivable that the nicotine affects the pain threshold," says the expert.
Source: Press release of the European Society of Anaesthesiology (ESA) from May 29, 2015
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