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Iida H, Yamaguchi S, Goyagi T, Sugiyama Y, Taniguchi C, Matsubara T, Yamada N, Yonekura H, Iida M. Consensus statement on smoking cessation in patients with pain. J Anesth 2022; 36:671-687. [PMID: 36069935 PMCID: PMC9666296 DOI: 10.1007/s00540-022-03097-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/13/2022] [Indexed: 11/30/2022]
Abstract
Smoking is closely associated with the development of various cancers and tobacco-related illnesses such as cardiovascular and respiratory disorders. However, data are scarce on the relationship between smoking and both acute and chronic pain. In addition to nicotine, tobacco smoke contains more than 4000 different compounds. Although nicotine is not the sole cause of smoking-induced diseases, it plays a critical role in pain-related pathophysiology. Despite the acute analgesic effects of nicotine, long-term exposure leads to tolerance and increased pain sensitivity due to nicotinic acetylcholine receptor desensitization and neuronal plastic changes. The purpose of smoking cessation interventions in smoking patients with pain is primarily not only to reduce their pain and associated limitations in activities of daily living, but also to improve the outcomes of underlying pain-causing conditions and reduce the risks of tobacco-related disorders. This statement aims to summarize the available evidence on the impact of smoking on pain and to inform medical professionals of the significance of smoking cessation in patients with pain.
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Affiliation(s)
- Hiroki Iida
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan. .,Department of Anesthesiology and Pain Medicine, Gifu University Graduate School of Medicine, Gifu, Japan. .,Anesthesiology and Pain Relief Center, Central Japan International Medical Center, 1-1 Kenkonomachi, Minokamo, Gifu, 505-8510, Japan.
| | - Shigeki Yamaguchi
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Anesthesiology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Toru Goyagi
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Anesthesiology, Akita University Hospital, Akita, Japan
| | - Yoko Sugiyama
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Woman Doctor Active Support in Perioperative Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.,Anesthesiology and Pain Relief Center, Central Japan International Medical Center, 1-1 Kenkonomachi, Minokamo, Gifu, 505-8510, Japan
| | - Chie Taniguchi
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,College of Nursing, Aichi Medical University, Nagakute, Japan
| | - Takako Matsubara
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe , Japan
| | - Naoto Yamada
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Anesthesiology, Iwate Medical University Hospital, Iwate, Japan
| | - Hiroshi Yonekura
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Anesthesiology and Pain Medicine, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Mami Iida
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Internal Medicine, Gifu Prefectural General Medical Center, Gifu, Japan
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Morgan ME, Kukora S, Nemshak M, Shuman CJ. Neonatal Pain, Agitation, and Sedation Scale's use, reliability, and validity: a systematic review. J Perinatol 2020; 40:1753-1763. [PMID: 33009491 DOI: 10.1038/s41372-020-00840-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/01/2020] [Accepted: 09/18/2020] [Indexed: 11/09/2022]
Abstract
The Neonatal Pain, Agitation, and Sedation Scale (N-PASS) is recommended by the American Academy of Pediatrics to measure neonatal pain and sedation. However, little is known regarding its reliability and validity for diverse neonatal subpopulations. Twenty-nine studies were included in our review, demonstrating broad application of N-PASS and good or excellent reliability and validity for various neonatal subpopulations. Our systematic review found N-PASS to be valid and reliable for many but not all neonatal subpopulations. There is a lack of support for N-PASS reliability and validity for measuring prolonged pain and sedation in nonmechanically ventilated infants and for acute pain in postoperative infants in any gestational age category. Overall, N-PASS is a psychometrically sound and pragmatic instrument evaluating pain and sedation for most neonatal populations. Future research using N-PASS is encouraged to evaluate and report its validity and reliability, especially for neonatal subpopulations not included in this review.
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Affiliation(s)
| | - Stephanie Kukora
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Michigan, Ann Arbor, MI, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Michelle Nemshak
- University of Michigan Pediatric-Perinatal Nursing, C.S. Mott Children's Hospital, Ann Arbor, MI, USA
| | - Clayton J Shuman
- School of Nursing, University of Michigan, Ann Arbor, MI, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
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Ozkan AS, Ucar M, Akbas S. The Effects of Secondhand Smoke Exposure on Postoperative Pain and Ventilation Values During One-Lung Ventilation: A Prospective Clinical Trial. J Cardiothorac Vasc Anesth 2018; 33:710-716. [PMID: 30093188 DOI: 10.1053/j.jvca.2018.06.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To investigate the relationships between secondhand smoke (SHS) exposure and oxygenation during one-lung ventilation (OLV) in lobectomy surgery and between SHS exposure and postoperative analgesic consumption. DESIGN Prospective study. SETTING University, Faculty of Medicine, operating room. PARTICIPANTS Sixty adult patients with American Society of Anesthesiologists score II to III, aged 18 to 65 years, with a body mass index (BMI) <35 kg/m2 scheduled for lobectomy surgery by open thoracotomy. INTERVENTIONS Patients were divided into 2 groups: the SHS group (n = 30) (urine cotinine level ≥6.0 ng/mL) and the NS (nonsmoker) group (n = 30) (urine cotinine level <6.0 ng/mL and no smoking history). SHS exposure was defined according to a previously published algorithm. MEASUREMENTS AND MAIN RESULTS Noninvasive blood pressure, electrocardiography, capnography, and peripheral oxygen saturation were monitored, and intra- and postoperative arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2), and intraoperative peak airway pressure were compared between the 2 groups. Postoperative analgesic consumption was calculated. No significant differences in demographics or preoperative data were noted between the 2 groups. PaO2 values 10 minutes after OLV onset and 10 minutes after the end of OLV were increased significantly in the NS group compared with those in the SHS group (p < 0.05). PaO2 values after 10 minutes of OLV in the NS and SHS groups were 285.5 ± 90 mmHg and 186.7 ± 66 mmHg, respectively. PaO2 values after OLV termination in the NS and SHS groups were 365.8 ± 58 mmHg and 283.6 ± 64 mmHg (p < 0.05), respectively. PaCO2 values 10 minutes after OLV onset, 10 minutes after the end of OLV, at the end of surgery, and upon arrival in the intermediate care unit were significantly different between the 2 groups (p < 0.05). CONCLUSION The present study demonstrated that during OLV, patients exposed to SHS exhibited significantly lower arterial oxygen pressure compared with nonsmokers. Arterial carbon dioxide values were increased significantly in SHS-exposed patients. Morphine consumption for postoperative analgesia also was increased in patients exposed to SHS compared with that in nonsmokers.
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Affiliation(s)
- Ahmet Selim Ozkan
- Department of Anesthesiology and Reanimation, Inonu University Medical Faculty, Malatya, Turkey.
| | - Muharrem Ucar
- Department of Anesthesiology and Reanimation, Inonu University Medical Faculty, Malatya, Turkey
| | - Sedat Akbas
- Department of Anesthesiology and Reanimation, Inonu University Medical Faculty, Malatya, Turkey
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Määttä AJ, Paananen M, Marttila R, Auvinen J, Miettunen J, Karppinen J. Maternal Smoking During Pregnancy Is Associated With Offspring's Musculoskeletal Pain in Adolescence: Structural Equation Modeling. Nicotine Tob Res 2017; 19:797-803. [PMID: 28003513 DOI: 10.1093/ntr/ntw325] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 12/07/2016] [Indexed: 12/12/2022]
Abstract
Introduction Smoking and behavioral problems are related to musculoskeletal (MS) pain in adolescence. Maternal smoking during pregnancy (MSDP) is associated with offspring's behavioral problems but its relation to MS pain in adolescence is unknown. Our purpose was to investigate whether there is an association between MSDP, the number of pain sites in adolescence, and the factors that potentially mediate this relationship. Methods We evaluated the association of MSDP with offspring's MS pain at 16 years among participants of the Northern Finland Birth Cohort 1986 (n = 6436, 3360 girls, 68% of all births) using Chi-square test and independent samples t test. We used structural equation modeling to assess the mediating factors stratified by gender. Results MSDP was frequent (22%) associating with paternal smoking (p < .001), externalization problems at 8 years (p = .009 boys, p = .002 girls), offspring's smoking at 16 years (p < .001), externalizing problems at 16 years (p < .001), family's social class (p < .001) and intactness of the family status (p < .001). The mean number of offspring's MS pain sites was higher among adolescents whose mothers had smoked during pregnancy than among those whose mothers were nonsmokers (p = .002 boys, p = .012 girls). The association between MSDP and MS pain at 16 years was mediated by externalizing problems at 8 years (p < .001) and 16 years (p < 0.001). Conclusions MSDP increased the risk of offspring's MS pain in adolescence, and the association was mediated by offspring's externalizing problems during childhood and early adolescence. Implications This study indicates that MSDP increases the risk of MS pain in adolescence and the effect is mediated by externalizing problems. Our results add to the evidence on harmfulness of MSDP for offspring, and can be used as additional information in interventions aiming to influence MSDP.
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Affiliation(s)
- Anni-Julia Määttä
- Department of Physical and Rehabilitation Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Markus Paananen
- Department of Physical and Rehabilitation Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Riikka Marttila
- Department of Physical and Rehabilitation Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Department of Physical and Rehabilitation Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Department of Physical and Rehabilitation Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jaro Karppinen
- Department of Physical and Rehabilitation Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Finnish Institute of Occupational Heath, Oulu, Finland
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