Vol. 7, Issue 1, Part A (2025)

Background: Among the most frequent side effects following surgical operations, post-operative nausea and vomiting (PONV) seriously affect patient comfort and recovery.

Aims of the study: Evaluate and compare the incidence of post-operative nausea and vomiting (PONV) between smoker and non-smoker patients undergoing laparoscopic surgery. Additionally, the study seeks to investigate the potential impact of smoking intensity on PONV outcomes and to explore the influence of anesthetic agents, particularly propofol, on mitigating these post-operative complications.

Methodology: This comparative study was conducted at Al Imam Ali General Hospital, Iraq, from February to May 2021, with ethical approval. One hundred patients (20-50 years old, ASA I or II) had laparoscopic surgery as part of the study. There were two groups of patients: 55 who did not smoke and 45 who did. Exclusion criteria included emergency surgery, rapid sequence induction, and ASA > II. Anesthesia induction was with thiopental or propofol, and maintenance used isoflurane. Patients were monitored post-surgery for nausea and vomiting, with treatment provided as needed. Post-extubation monitoring lasted one hour.

Result: The study found significant differences in nausea and vomiting post-surgery between non-smokers and smokers. The group of people who didn't smoke had higher rates of nausea (38.1% vs. 24.9%) and vomiting (36.3% vs. 33.3%), which was statistically significant (p<0.01 and p<0.03, respectively). The group of people who didn't smoke also had higher rates of nausea and vomiting together (74.5% vs. 57.7%, p<0.001). In the smokers group, there was no significant difference between moderate and heavy smokers when it came to post-operative symptoms.

Conclusions: The study concludes that smoking significantly reduces the incidence of post-operative nausea and vomiting (PONV). This effect may be attributed to the anti-emetic properties of nicotine and other chemicals in cigarette smoke, which potentially influence neurotransmitter pathways and enzyme induction, thereby modulating drug metabolism and PONV occurrence.