Faculty Collaboration Database

Acute smoking increases ST depression in humans during general anesthesia. Anesth Analg 1999 Oct;89(4):856-60

Date

10/08/1999

Pubmed ID

10512255

DOI

10.1097/00000539-199910000-00008

Scopus ID

2-s2.0-0032882369 (requires institutional sign-in at Scopus site)   58 Citations

Abstract

UNLABELLED: We tested the hypothesis that acute smoking is associated with ST segment depression during general anesthesia in patients without ischemic heart disease. The carbon monoxide (CO) concentration in expired gas and hemodynamic data was measured during general anesthesia for noncardiac or nonperipheral vascular surgery in patients without symptoms or evidence of ischemic heart disease. Increased expired CO concentrations are indicators of recent smoking. Logistic regression analysis identified significant predictors of ST segment depression > or = 1 mm. Both rate pressure product (odds ratio 1.20 for each increase of 1000, 95% confidence interval = 1.04-1.41, P = 0.007) and expired CO concentration (odds ratio 1.05 for each part per million increase, 95% confidence interval = 1.03-1.08, P = 0.001) were significant predictors of ST segment depression when considered simultaneously. Males demonstrated a lower probability of having an episode of ST depression (odds ratio = 0.16, P = 0.01), but this did not change the relationship between rate pressure product and CO as predictors of ST depression. Approximately 25% of chronically smoking patients smoked on the morning of surgery despite instructions not to smoke.

IMPLICATIONS: Patients under age 65 without symptoms of ischemic heart disease who smoked shortly before surgery had more episodes of rate pressure product-related ST segment depression than nonsmokers, prior smokers, or chronic smokers who did not smoke before surgery. Females were at greater risk of ST depression than males.

Author List

Woehlck HJ, Connolly LA, Cinquegrani MP, Dunning MB 3rd, Hoffmann RG

Authors

Michael P. Cinquegrani MD Director, Professor in the Medicine department at Medical College of Wisconsin
Lois A. Connolly MD Professor in the Anesthesiology department at Medical College of Wisconsin
Harvey J. Woehlck MD Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adult
Anesthesia, General
Anesthetics, Inhalation
Blood Pressure
Carbon Monoxide
Chronic Disease
Confidence Intervals
Electrocardiography
Female
Forecasting
Heart Rate
Humans
Isoflurane
Logistic Models
Male
Methyl Ethers
Middle Aged
Odds Ratio
Sex Factors
Smoking
Smoking Cessation
Spirometry
Vascular Surgical Procedures