Navigation Links
Children exposed to secondhand tobacco or cooking smoke have very high rates of pain and complications after tonsillectomy

New research presented at this year's Euroanaesthesia meeting in Stockholm shows that children exposed to indoor coal-burning stoves and/or second-hand tobacco smoke are much more likely to suffer postoperative complications and excessive pain after tonsillectomies. The research is by Professor Daniel Sessler, Cleveland Clinic, Cleveland, Ohio, USA and Dr Onur Koyuncu, Mustafa Kemal University, Hatay, Turkey, and colleagues.

Almost half of the world's population uses solid fuel including biomass (wood, crop residues, and animal dung) or coal for heating and cooking. Because stoves are usually centrally positioned in homes and often the only source of heat, families tend to congregate around them and sleep nearby. Many stoves generate and release pollutants into household air including carbon monoxide. Children are also exposed to carbon monoxide via second-hand tobacco smoke, with estimates suggesting 40-70% of children are exposed worldwide.

Exposure to carbon monoxide results in carboxyhaemoglobin*, which may provoke postoperative complications. Elevated carboxyhaemoglobin concentrations may also increase pain sensitivity. The investigators therefore tested the primary hypothesis that children with high preoperative carboxyhaemoglobin concentrations have more postoperative complications and pain after tonsillectomies. Secondarily they tested the hypothesis that high carboxyhaemoglobin concentrations are associated with more pain and painkiller use.

100 Turkish children scheduled for elective tonsillectomy were divided into low and high carbon monoxide exposure groups: carboxyhaemoglobin ≤3 or ≥4 g/dl. The primary outcome was complications during the seven days after surgery which included bronchospasm, laryngospasm, persistent coughing, desaturation (low blood oxygen), the need for re-intubation, low blood pressure, postoperative bleeding, and reoperation. Pain was evaluated with Wong-Baker Faces pain scales, and supplemental use of the painkiller tramadol was recorded for four hours postoperatively.

There were 36 patients in the low exposure group carboxyhemoglobin [mean 1.8 g/dl], and 64 patients were in the high exposure group [mean 6.4 g/dl]. Indoor coal-burning stoves were reported more often by families of the high than low carboxyhemoglobin children (89% versus 72%). Second-hand cigarette smoke exposure was reported by 54% of the families with children with high carboxyhaemoglobin, but only by 24% of the families of children with low carboxyhaemoglobin .

Complications were more common in patients with high carboxyhaemoglobin (47% versus 14% in the low group), with most occurring in the postanaesthesia care unit. Pain scores in the postanaesthesia care unit and one hour after surgery were significantly lower in the low exposure group. Similarly, tramadol use was lower in the low-exposure group at both 4 hours (3.5 vs. 6.0 mg) and 24 hours (3.5 vs. 6.0 mg).

The authors conclude: "Children exposed to substantial environmental carbon monoxide have more complications and more pain after general anaesthesia than less exposed children."


Contact: Daniel I. Sessler
ESA (European Society of Anaesthesiology)

Related medicine news :

1. IntegraGen launches ARISk test, a genetic screening tool for autism in high-risk children
2. In children born with severe heart defect, surgical management has little effect on neuro outcomes
3. Children Born to Obese Moms May Face Higher Autism Risk: Study
4. Supporting LGB children may influence their long-term health, BU study finds
5. Out-of-hand tree nut consumption associated with better diet quality in children and adults
6. BASPCAN - UK-wide increase in number of children
7. Nearly 1 in 4 grandparents store prescription medicines where children can easily find them
8. U.S. Children Exposed to Hours of Background TV Daily
9. Leaders in childrens health to gather in Boston
10. Dietary changes help some children with ADHD
11. Bullied Children at Greater Risk for Self-Harm, Study Finds
Post Your Comments:
(Date:6/26/2016)... ... June 26, 2016 , ... PawPaws brand pet ... product that was developed to enhance the health of felines. The formula is all-natural ... two main herbs in the PawPaws Cat Kidney Support Supplement Soft Chews ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... and applications at AcademyHealth’s Annual Research Meeting June 26-28, 2016, at the Hynes ... important health care topics including advance care planning, healthcare costs and patient and ...
(Date:6/25/2016)... ... June 25, 2016 , ... "With 30 hand-drawn hand gesture animations, FCPX ... Austin - CEO of Pixel Film Studios. , ProHand Cartoon’s package transforms over ... Cut Pro X . Simply select a ProHand generator and drag it above media ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... recover from injury. Recently, he has implemented orthobiologic procedures as a method for ... is one of the first doctors to perform the treatment. Orthobiologics are substances ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... A recent ... that most people are unfamiliar with. The article goes on to state that individuals ... also many of these less common operations such as calf and cheek reduction. The ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... -- Research and Markets has announced ... Applications, Technologies, Forecasts" report to their offering. ... Smart Skin, Structural Health Monitoring, Composite Smart Structures, ... involves electronic and/or electrical components and circuits that ... such as vehicle bodies or conformally placed upon ...
(Date:6/24/2016)... According to a new market ... Needles, Safety Pen Needles), Needle Length (4mm, 5mm, 6mm, ... of Purchase (Retail, Non-Retail) - Trends & Global Forecasts ... market for the forecast period of 2016 to 2021. ... by 2021 from USD 1.65 Billion in 2016, growing ...
(Date:6/23/2016)... 23, 2016 Research and Markets has ... - Forecast to 2022" report to their offering. ... for the patients with kidney failure, it replaces the function ... the patient,s blood and thus the treatment helps to keep ... in balance. Increasing number of ESRD patients ...
Breaking Medicine Technology: