NEW YORK (Reuters) -- Children exposed to secondhand smoke are more likely than their peers to have complications of general anesthesia when undergoing surgery, according to a study.
"There is strong association between passive inhalation of tobacco smoke and airway complications in children receiving general anesthesia," reported lead author Dr. Eric T. Skolnick in the journal Anesthesiology. "The relationship is greatest for girls and for those whose mothers have a lower level of education," according to Skolnick, an assistant professor of anesthesiology and pediatrics at Columbia University College of Physicians and Surgeons in New York.
Skolnick and colleagues looked at nearly 500 children, aged 1 month to 12 years, who underwent general anesthesia, and who were assessed by a recovery room nurse who was unaware of their exposure to secondhand smoke.
There were airway complications -- such as inability to ventilate the patient's lungs, wheezing, a spasm of bronchial tubes requiring treatment, or severe coughing -- in 42% of youngsters with the highest exposure to tobacco smoke, as measured by levels of cotinine, the major breakdown product of nicotine, in their urine. There were airway complications in 33% of children with moderate levels of cotinine and in 24% of those with the lowest levels.
Overall, children exposed to the smoke from 30 cigarettes a day had twice the risk of respiratory complications as other children during general anesthesia.
"When all of the detrimental effects of environmental tobacco smoke on children are considered, especially those in asthmatic children, smoking in households where there are children may well become the next issue in child abuse," writes former Surgeon General Dr. C. Everett Koop in an accompanying editorial.
SOURCE: Anesthesiology (1998;88:1144-1153)
