Background and objective: It has been demonstrated that smoking significantly reduces postoperative nausea and vomiting (PONV). However, there are approximately 4000 substances in cigarette smoke that can be responsible for this effect. To demonstrate whether nicotine is the substance with antiemetic effects we applied a nicotine patch in patients undergoing laparoscopic cholecystectomy under general anaesthesia.
Methods: Seventy-five patients classified as ASA (American Society of Anesthesiologists’ classification) I/II were divided in three groups: group 1 (n = 25), which comprised non-smokers; group 2 (n = 25), which comprised patients who had given up smoking for the last 5 years and received perioperatively a nicotine patch that contained 16.6mg nicotine/patch; and group 3 (n = 25), which comprised actual smokers. Postoperatively, the incidence of PONV and the need for antiemetic rescue medication were monitored every 6 hours.
Results: We found a significant reduction in the incidence of PONV in group 2 (5/ 25 [20%], p = 0.0001 vs group 1) and group 3 (8/25 [32%], p = 0.002 vs group 1) compared with group 1 (18/25 [76%]). The difference in incidence of PONV between group 2 and group 3 was not significant (p > 0.05).
Conclusions: Nicotine significantly reduced the incidence of PONV after laparoscopic cholecystectomy.
The authors gratefully acknowledge the invaluable assistance of Dr Horatiu Vasian, Department of Anaesthesia and Intensive Care, University of Medicine and Pharmacy, Cluj-Napoca, Romania, in the preparation of this manuscript and of Mrs Cosmina Bondor, Department of Medical Statistics, University of Medicine and Pharmacy, Cluj-Napoca, Romania, for the statistical analysis.
No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.
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