Secondhand Smoke Adds to Surgical Risk.

Medical researchers have established a clear link between secondhand tobacco smoke and serious breathing problems for children who receive general anesthesia. Girls are at greater risk, especially those whose mothers have a lower level of education, according to a study by Eric T. Skolnick, assistant professor of anesthesiology and pediatrics, Columbia University College of Physicians and Surgeons, New York, and a group of researchers.

Over a 16-month period, they observed 499 children ages one month to 12 years who were scheduled to receive general anesthesia for surgery. The youngsters' exposure to tobacco smoke was confirmed by testing their urine for the presence of the substance cotinine, the most common by-product and indicator of nicotine exposure. The study found that the proportion of patients experiencing airway complications following general anesthesia was linked directly to the concentration of the nicotine by-product in their urine. These included a lack of oxygen in the blood, severe coughing, and airway spasms as they were being given anesthesia, when anesthesia was stopped, and later in the recovery room.

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