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anesthesiologist & smoking

mountaingirlmmountaingirl Posts: 8
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
Why are Anesthesiologists so concerned about quitting smoking before surgery? My surgery is scheduled for next tues. and meet with the anesthesiologist this thurs. Is it true they can prevent you from having your surgery? Can they really make that decision? :S



  • Howdy Mountaingirl,

    My previous surgery, the anesthesiologist was very angry that they didn't tell *him* that I smoked. He blurted something about some test he wanted to do on me since I smoked, but in the same breath while looking at his watch said "It was too late, lets just do this." Then he stomped off. Since it is his job to keep you breathing and under, he can stop the surgery.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • SpineAZSpineAZ WiscPosts: 1,084
    A smoker will have possibly diminished lung capacity and some lung disease (even if undiagnosed). If an anesthesiologist is not told that you are a smoker they may not be able to provide adequate medication and ventilation. If an anesthesiologist feels that it is unsafe to operate, for any reason, they can consult with the surgeon as to whether surgery should go forward.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • In the hands of the anesthesiologist when you have surgery. It's the last person you want to make angry or have a disagreement with. As the others have said, there could easily be diminished capacity as well as the fact that your red blood cells can't absorb as much oxygen as needed. Smoking introduces carbon monoxide into the body which binds to the hemoglobin 200 times faster than oxygen. So a smokers capacity to absorb the anesthesia gases and O2 is seriously impaired.

  • I'm surprised your surgeon hasn't made a big deal out of it. At least if you are getting a fusion. Maybe for a lami or disco they don't make much noise. My first surgery was a microD and the ortho surgeon told me to quit smoking. For the fusion the neurosurgeon wanted me quit for a year prior to surgery. Also threatened to test for it when I did my pre-surgery tests.

    At the end of the day no doctor likes the idea of you smoking. Most certainly not if you are up for surgery. As stated above the anesthesiologist has to keep you under and alive. When I did my pre-op the anesthesiologist asked me how long ago I quit smoking. I told him 2 years. He said it should be ok then but I would always have some damage.
  • very difficult to ventilate a patient who smokes...period. You can google how problematic it can become. Anesthesia providers take on a huge liability when a patient is unhealthy for a variety of reasons, whether it is self-induced or not.

    It is always best if you take on general anesthesia at your healthiest state. Anesthesia is not benign, but saying that, it is your choice...but, be informed!
  • Thanks everyone for your input. I had a fusion done 17 years ago & smoked before & after. Well come to find out my fusion did not fuse all the way. I know it was from my smoking. I tried stopping for a month but when I found out last friday my surgery was scheduled for 5/11 & it has freaked me out. I am definitley quitting after I have the surgery & when I get out of the hospital. I know I can do it. I've done it before. I don't want to jepoardize my recovery again. It's what has brought me back to another surgery. I'm afraid to tell the anesti.
  • NOW...if you can...It really takes weeks to repair the damage that you do to your lungs. You don't want to have complications from lung issues since you are going to be asleep for several hours.

    Your anestheiologist will know you smoke, even if you don't tell him, so you might as well confess. Patients who smoke do not act normal lung wise under anesthesia, so we always know.

    The sooner you quit, the sooner you repair.

    Much luck, and take care,


  • Get the quitting part over with now. Smoking does bad things to your lungs and body. To say your going to quit after the surgery says, to me, that you have no intention of quitting but maybe cutting back. Being under anesthesia causes problems all by itself let alone having issues from something you can stop. It is very hard to figure out how much of the drugs they are giving you are actually working because of your decreased lung capacity. Set you mind to it and stop. I smoked for 20 years and I know it can be hard to do but once you make up you mind it can be done. Its up to you. Nobody can stop it for you. If I was a Dr. I wouldn't operate on a patient that smoked. Kind of harsh I know but you said yourself that thats why you didn't fuse so the writing is on the wall.

  • I don't smoke and haven't ever, other than a couple puffs with a girlfriend in a bar in my youth.

    A day after my 360 lumbar fusion, I developed pneumonia and plurecy which is an imflammation of the lining of the lung. Feels much like sandpaper against your lung with any breathe or move.

    On Sat., I started showing symptoms, they called a code blue. I struggled for 2 days until monday when my surgeon came to visit.

    I can't describe how aweful it is to not be able to breathe. You just panic. You can't eat or drink and you have to find a resting position that includes your mouth being open.

    I am not trying to scare you, I just wanted to let you know what happened to me. I am relatively young, so healthy my personal physician put my chart in storage it's been so long since I needed him.

    We are all here to support you in any way needed! Best of luck!
  • This won't help you, Mountaingirl, but perhaps it will encourage other smokers who are contemplating surgery to stop:

    "The good news is that patients who quit for more than four weeks do seem to have a decreased risk of complications. In addition, patients who are able to quit for ten weeks or more have their risk reduced to almost the same as patients that have never smoked. Smoking cessation is not futile - and should be encouraged in patients that have surgery and anesthesia scheduled more than a month in advance. The data is encouraging in that patients that indeed quit can reduce their risk to close to nonsmokers in as little as ten weeks. The motivation to decrease their risk for anesthesia may be the motivator that some patients need to quit for good. This is a positive step to take, not just for anesthesia, but for overall health and well-being."
    from http://anesthesiologyinfo.com/articles/12012003.php
  • Thank you all for the information! I had my preop today. Everything is ok to proceed. I was honest about the smoking thing too. The reason why I was asking about smoking is because I had no idea I was going to have surgery so soon! I got my mri results in the middle of Apr. & waalaa, they had an opening May 11 because of Neurosurgeon, anest, & pulminary drs. had to come up with a schedule for all of them to be there. I quit for 2 weeks the end of mar. quit for 2 weeks in apr. & when I found out last fri. surgery was so soon, I freaked & started smoking again. Intend to quit completely though. You know what they say! Third times a charm! God willing.
  • I smoked for 28 years. I was able to quit 7 weeks prior to my surgery. And I was so happy I did. I did not have the issues that I had with previous surgeries. Of course, all gen. anesthesia causes some fluid in the lungs, but this was so much easier to hack up. I did not have to cough as long or hard. Good thing considering my back was flayed open /:) Anyway, quit as soon as possible. Try Chantix if you haven't already. It was much easier for me to quit with it. I hope your surgery and recovery are speedy!!

  • because as previously mentioned your lung will have a degree of reduced capacity {even if you are a fit young person} not only that your blood gasses are different and your blood is stickier than a none smoker .if your anesthetist knows that you are or have been a smoker he or she can make certain adjustment for this but its best to quit smoking at least 6 months before surgery and take up swimming to help your lung capacity .i smoke myself so please don't think i am preaching .i intend to stop anyway .weather i have my surgery or not .i have found that honesty is the best policy if the surgeons and his.her team know your state of health then you stand a better chance of a favorable outcome on your surgery .in other words if they know that you are not in the best if health .then they can make appropriate adjustment during and after surgery .{my last anesthetist was a smoker!..so they are not all perfect!}
  • I'm on wellbutrin & had the patches & had quit the 2x but I am really gearing myself up for this. I know it is going to be difficult with the pain & extra time on my hands but I know I have to do it. I found out in Feb this year my brother has lung cancer & it has really hit hard. My surgery is happening so fast that I haven't had time to get weeks and weeks or months and months of quitting smoking behind me. I was doing hot yoga which was very strenuous and it was a great cardio workout, I loved it. Am in pretty good shape, but quit about 1 1/2 months ago & feeling it already. I know I will never be able to do that again. I really appreciate all the comments. Thanks again.
  • Why did your mother let you start smoking when you were four or five??

    (Lest my attempt at humor miss its mark, you do not look nearly old enough to have smoked for 28 years!)
  • LOL @ Gwennie,

    That was funny!! I am actually 43 and started smoking when I was 15. My mom was so mad at me for it. She bugged me to quit for almost 15 years, until she passed. I wish I could tell her I finally quit.

    But you are a hoot and have the kind of sense of humor I like!!
  • Tracee, I thought the same thing! You definately don't look like you could be in your 40's! :-)

    Your mom knows you quit and she is soooo proud of you!
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