FREQUENCY OF PERIOPERATIVE RESPIRATORY COMPLICATIONS IN SMOKERS UNDERGOING GENERAL ANESTHESIA AT LADY READING HOSPITAL, PESHAWAR

Abstract

Background: Perioperative respiratory complications remain a significant concern in surgical patients, particularly smokers, despite advancements in anesthesia and surgical techniques. Smoking is a modifiable risk factor associated with increased incidences of laryngospasm, bronchospasm, desaturation, and other adverse events during the perioperative period. This study aimed to determine the frequency of such complications in smokers undergoing general anaesthesia at Lady Reading Hospital (LRH), Peshawar. Methods: A descriptive cross-sectional study was conducted at LRH. The study period spanned six months, from July 1, 2022, to January 2023.  Ethical approval was obtained from the institutional review board (IRB) of LRH (LRH; A3429).involving 80 male smokers aged 18-45 years. Convenience sampling was employed. Patients with respiratory comorbidities, users of other tobacco products, or those classified as ASA III or higher were excluded. Perioperative respiratory events were monitored from the induction of anaesthesia until transfer from the operating room. Complications included desaturation (SpO₂ <90% for >10 seconds), laryngospasm (audible stridor unrelieved by manual airway manoeuvres), and bronchospasm (wheezing on auscultation with reduced lung compliance and prolonged ETCO₂ upstroke). Data were analysed using SPSS version 22. Results: Of the 80 planned participants, 70 were evaluated due to time constraints. Postoperative desaturation occurred in 13 patients (18.6%), while no cases of intraoperative desaturation, laryngospasm, or bronchospasm were observed. This frequency highlights desaturation as the predominant event in this cohort. Conclusion: Approximately one in five smokers developed perioperative respiratory complications, primarily postoperative desaturation. Adherence to guidelines from the British Thoracic Society (BTS), American Society of Anesthesiologists (ASA), and Canadian Anesthesiologists' Society for preoperative smoking cessation could mitigate these risks. Integrating smoking cessation protocols into perioperative care is recommended to improve outcomes.