PERIOPERATIVE RESPIRATORY EVENTS IN SMOKERS AND NONSMOKERS UNDERGOINGGENERAL-ANESTHESIA

Background: The prevalence of respiratory diseases in smokers and nons mokers and the incidence of perioperative respiratory events (PREs) we re investigated for patients undergoing general anaesthesia. The aim w as to quantify well-known problems and to identify possible new associ ations between smoking and PREs.Methods: From July 1992 to December 19 94, risk factors, demographic data, and PREs were documented by an aut omatically readable anaesthetic record (ARAR). PREs were used as defin ed by the German Society of Anaesthesiology and Intensive Care. Result s: Of 26 961 subsequent anaesthesias in adults, 7122 (26.4%) were perf ormed in smokers with a prevalence of chronic bronchitis of 23.3% (4.8 % in nonsmokers). 1573 PREs occurred in 1397 (5.2%) of all anaesthetic s. 459 events concerned intubation problems and problems in technical airway management. 1114 specific respiratory events (SPREs) like re-in tubation, laryngospasm, bronchospasm, aspiration, hypoventilation/hypo xaemia and others had a total incidence of 5.5% in smokers and 3.1% in nonsmokers. The relative risk (RR) of SPREs was 1.8 in all smokers, 2 .3 in young (16-39 years) smokers, and 6.3 in obese young smokers. The RR of perioperative bronchospasm was 25.7 in young smokers with chron ic bronchitis. Conclusion: The impact of smoking on perioperative resp iratory problems should make anaesthetists take this widespread preope rative condition seriously, particularly in young adults. The presente d method of incident reporting (based on a national classification) co uld contribute to future research in anaesthetic epidemiology. (C) Act a Anaesthesiologica Scandinavica 41 (1997).