Year: 2012
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Background Even brief preoperative abstinence from smoking can favorably affect intra-operative physiologic parameters such as carboxyhemoglobin concentrations, but many patients continue to smoke the morning of surgery. Objective The goal of this pilot study was to determine the feasibility and potential effect size of nicotine lozenges as an adjunct to maintain brief preoperative abstinence, defined as not smoking the day of surgery. Methods Forty six cigarette smokers scheduled for elective surgery were randomized in a double-blinded fashion to receive active or placebo nicotine lozenges, beginning the night prior to surgery, combined with brief advice to both groups to maintain abstinence on the morning of surgery. The primary outcome was the exhaled carbon monoxide (CO) level in the preoperative holding area. Results Preoperative CO levels tended to be less in the active group (8.3 ± 7.5 and 12.7 ± 10.9 ppm in active and placebo groups, respectively, p = 0.12, Cohen’s d = 0.47). Of the 46 subjects, 26 (57 %) tried at least one lozenge, with proportions similar in both groups. When those who tried at least one lozenge were analyzed, preoperative CO levels were significantly lower in those who received active lozenges (3.8 ± 3.0 and 12.7 ± 11.5 ppm in active and placebo groups, respectively, p = 0.009). Conclusion This study suggests the feasibility of nicotine lozenges as an aid to maintain brief preoperative abstinence and provided preliminary evidence of efficacy. Methods to increase lozenge utilization, and a larger efficacy trial, are indicated.
Authors: David O. Warner, Sandeep Kadimpat
Institution: Mayo Clinic
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funder: Mayo Clinic
OpenAlex ID: W2887773156