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Relationship between pain outcomes and smoking history following video-assisted thoracic surgery for lobectomy: a retrospective study

Authors Oh TK, Kim K, Jheon S, Do SH, Hwang JW, Kim JH, Jeon YT, Song IA

Received 24 November 2017

Accepted for publication 7 February 2018

Published 6 April 2018 Volume 2018:11 Pages 667—673


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Katherine Hanlon

Tak Kyu Oh,1 Kwhanmien Kim,2 Sanghoon Jheon,2 Sang-Hwan Do,1 Jung-Won Hwang,1 Jin Hee Kim,1 Young-Tae Jeon,1 In-Ae Song1

1Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; 2Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, Korea

Purpose: The relationship between chronic smoking history and postoperative pain remains controversial. This study aimed to elucidate this relationship in non-small cell lung cancer (NSCLC) patients who underwent video-assisted thoracic surgery (VATS) lobectomy.
Patients and methods: This retrospective observational study included NSCLC patients treated with VATS lobectomy between January 2011 and July 2017. Demographic and clinical information, including preoperative smoking history, was collected. The primary goal was to investigate the relationship between smoking history and postoperative pain outcomes (oral morphine equivalent [OME] consumption and pain score). Multivariate linear regression analysis was performed, and P<0.05 was considered as statistically significant.
Results: A total of 1,785 patients were included in the final analysis. Multivariate linear regression analysis revealed that total smoking amount (in packs), status as current smoker, and cessation time did not have an association with OME consumption (mg) or pain scores on postoperative days 0–2 (P>0.05). However, patients who had never smoked consumed less morphine equivalent analgesics (mg) on postoperative days 0–2 (coefficient: −17.48, 95% CI [−33.83, −1.13], P=0.036) compared to patients who had a history of smoking.
Conclusion: Patients who had never smoked had lower opioid analgesics consumption on the days immediately following surgery, while being a current smoker or the total amount of smoking in packs did not affect postoperative pain outcomes after VATS lung lobectomy.

Keywords: anesthesia, analgesia, opioid, postoperative pain, smoking

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