Patients undergoing surgery are instructed to abstain from smoking for a period before their procedure, often at least 24 hours. Adhering to this guideline is important for patient safety and contributes to more favorable surgical outcomes by minimizing various risks associated with smoking during the perioperative period.
Immediate Impact on Respiratory Function
Smoking, even shortly before surgery, can compromise the respiratory system. It increases mucus production and inflammation within the airways, potentially leading to complications. Cilia, responsible for clearing debris and secretions, become less effective in smokers. This reduced ciliary function allows mucus to build up, increasing respiratory risks.
Carbon monoxide binds to hemoglobin, reducing its ability to transport oxygen effectively. This diminished oxygen-carrying capacity means tissues and organs receive less oxygen, making them more vulnerable. These factors increase the likelihood of respiratory complications such as pneumonia, lung collapse, and bronchospasm (narrowing of airways) during and after surgery. Patients who smoke are also more likely to require a ventilator after surgery.
Cardiovascular System and Blood Health
Smoking affects the cardiovascular system, posing risks during surgery. Nicotine stimulates the adrenal glands, increasing heart rate and blood pressure. This stress, coupled with constricted blood vessels, makes the cardiovascular system less resilient during surgery.
Carbon monoxide further reduces oxygen-carrying capacity, forcing the heart to work harder. Smoking also makes blood “stickier,” increasing its clotting tendency. This increases the risk of blood clots, which can lead to heart attack or stroke during and after surgery. These effects can result in poor circulation and an increased risk of cardiac complications.
Anesthesia Interactions and Recovery
Smoking can alter how the body responds to anesthetic medications. Chemicals in smoke induce liver enzymes, increasing the metabolism of anesthetic drugs. This accelerated metabolism may necessitate higher anesthesia doses or lead to unpredictable drug effects, making it more challenging to maintain stable sedation levels.
Beyond anesthesia, nicotine and other smoke components impair healing processes. Smoking reduces blood flow to surgical sites, delaying wound healing and increasing infection risk. A compromised immune system also heightens infection susceptibility. This can result in a longer, more complicated recovery and potentially extended hospital stays.
The Critical 24-Hour Window
Even short abstinence from smoking offers immediate physiological benefits that reduce surgical risks. Within 24 hours of quitting, carbon monoxide levels drop significantly. This allows hemoglobin to carry more oxygen, improving oxygen delivery to tissues. Reduced irritants also immediately decrease airway irritation.
While 24 hours provides immediate improvements, longer abstinence offers more profound health benefits. Quitting for weeks or months prior to surgery further reduces complications and improves recovery. Adhering to the surgical team’s specific instructions is important, as these guidelines optimize patient safety and surgical outcomes.