# The effects of smoking on pain scores, vital signs, and analgesic consumption in patients undergoing tympanomastoidectomy surgery

## TL;DR

This study finds that smokers experience higher pain and need more pain medication after ear surgery compared to non-smokers.

## Contribution

The study identifies a novel association between smoking and increased postoperative analgesic consumption and pain scores in tympanomastoidectomy patients.

## Key findings

- Smokers had higher postoperative pain scores and analgesic consumption compared to non-smokers.
- Smokers experienced earlier onset of postoperative pain and higher preoperative carboxyhemoglobin levels.
- Smoking was associated with increased postoperative nausea and lower oxygen saturation in smokers.

## Abstract

In this study, we investigate the effects of smoking on pain scores, vital signs, and analgesic consumption in the intraoperative and postoperative period in patients undergoing tympanomastoidectomy surgery.

A total of 100 patients with American Society of Anesthesiologists I-II status, aged 18–55 years, and who were planned to undergo tympanomastoidectomy surgery were divided into two groups: smokers (Group 1) and non-smokers (Group 2). The patients were compared for preoperative, intraoperative, and 24-hour postoperative carboxyhemoglobin, blood pressure, oxygen saturation, respiratory rate, heart rate, pain intensity and verbal numerical rating scales, the extent of patient-controlled tramadol dose, nausea, and vomiting.

There were 50 individuals in each group. Postoperative analgesic consumption and pain scores were higher in Group 1, and the first postoperative pain was felt earlier. Furthermore, in Group 1, preoperative carboxyhemoglobin levels and postoperative nausea were statistically higher before, after, and at the tenth minute after induction, whereas oxygen saturation was lower. The two groups had no statistical difference regarding intraoperative and postoperative vital signs. Postoperative analgesic consumption was not affected by age or gender.

Smoking changes postoperative pain management, especially for this kind of operation, and these patients feel more pain and need more postoperative analgesic doses. Therefore, effective postoperative pain control should take account of smoking behavior, and analgesic doses may need to be adjusted for patients who smoke.